Journal Article (Review Article)

DZNE-2023-01193

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png A prospective observational study of real-world treatment and outcome in secondary CNS lymphoma.

Habringer, S. ; Demel, U. M. ; Fietz, A.-K. ; Lammer, F. ; Schroers, R. ; Hofer, S. ; Bairey, O. ; Braess, J. ; Meier-Stiegen, A. S. ; Stuhlmann, R. ; Schmidt-Hieber, M. ; Hoffmann, J. ; Zinngrebe, B. ; Kaiser, U. ; Reimer, P. ; Möhle, R. ; Fix, P. ; Höffkes, H.-G. ; Langenkamp, U. ; Büschenfelde, C. M. Z. ; Hopfer, O. ; Stoltefuß, A. ; La Rosée, P. ; Blasberg, H. ; Jordan, K. ; Kaun, S. ; Meurer, A. ; Unteroberdörster, M. ; von Brünneck, A.-C. ; Capper, D.DZNE* ; Heppner, F. L.DZNE* ; Chapuy, B. ; Janz, M. ; Schwartz, S. ; Konietschke, F. ; Vajkoczy, P. ; Korfel, A. ; Keller, U.

2024
Elsevier Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.ejca.2023.113436

Abstract: Secondary central nervous system lymphoma (SCNSL) confers a dismal prognosis and treatment advances are constrained by the lack of prospective studies and real-world treatment evidence.Patients with SCNSL of all entities were included at first diagnosis and patient characteristics, treatment data, and outcomes were prospectively collected in the Secondary CNS Lymphoma Registry (SCNSL-R) (NCT05114330).279 patients from 47 institutions were enrolled from 2011 to 2022 and 243 patients (median age: 66 years; range: 23-86) were available for analysis. Of those, 49 (20 %) patients presented with synchronous (cohort I) and 194 (80 %) with metachronous SCNSL (cohort II). The predominant histology was diffuse large B-cell lymphoma (DLBCL, 68 %). Median overall survival (OS) from diagnosis of CNS involvement was 17·2 months (95 % CI 12-27·5), with longer OS in cohort I (60·6 months, 95 % CI 45·5-not estimable (NE)) than cohort II (11·4 months, 95 % CI 7·8-17·7, log-rank test p < 0.0001). Predominant induction regimens included R-CHOP/high-dose MTX (cohort I) and high-dose MTX/cytarabine (cohort II). Rituximab was used in 166 (68 %) of B-cell lymphoma. Undergoing consolidating high-dose therapy and autologous hematopoietic stem cell transplantation (HDT-ASCT) in partial response (PR) or better was associated with longer OS (HR adjusted 0·47 (95 % CI 0·25-0·89), p = 0·0197).This study is the largest prospective cohort of SCNSL patients providing a comprehensive overview of an international real-world treatment landscape and outcomes. Prognosis was better in patients with SCNSL involvement at initial diagnosis (cohort I) and consolidating HDT-ASCT was associated with favorable outcome in patients with PR or better.

Keyword(s): Humans (MeSH) ; Aged (MeSH) ; Prospective Studies (MeSH) ; Antineoplastic Combined Chemotherapy Protocols: adverse effects (MeSH) ; Lymphoma, Large B-Cell, Diffuse: drug therapy (MeSH) ; Lymphoma, Large B-Cell, Diffuse: etiology (MeSH) ; Hematopoietic Stem Cell Transplantation: adverse effects (MeSH) ; Rituximab: therapeutic use (MeSH) ; Treatment Outcome (MeSH) ; Transplantation, Autologous (MeSH) ; Central Nervous System Neoplasms: drug therapy (MeSH) ; Retrospective Studies (MeSH) ; Observational Studies as Topic (MeSH) ; Autologous stem cell transplantation ; High-dose chemotherapy ; Real-world data ; Registry study ; SCNSL ; Secondary Central Nervous System Lymphoma ; Rituximab

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Contributing Institute(s):

1. Neuroimmunology (AG Heppner)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2024

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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