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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(01): 036-039
DOI: 10.1055/s-0043-1761229
Original Article

Prognostic Factors of the Primary Central Nervous System Lymphoma: Clinical Experience from a Tertiary Care Center in the Middle East

Hannan Ebrahimi
1   Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
2   Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Mohsen Esfandbod
3   Department of Hematology-Oncology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Seyed Mehdi Ketabchi
2   Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Kourosh Karimi Yarandi
2   Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Mohamad Shirani
2   Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Abbas Amirjamshidi
2   Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Maysam Alimohamadi
1   Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
2   Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
› Author Affiliations Funding None.
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Abstract

Aim Primary central nervous system lymphoma (PCNSL) is a rare extra nodal non-Hodgkin's lymphoma. The optimal treatment for PCNSL is still unclear. In this study, we present our experience with management of PCNSL in a tertiary care center in Iran.

Methods In this retrospective study, 58 patients with tissue diagnosis of PCNSL were studied. All patients were treated with chemotherapy including intravenous high-dose methotrexate, rituximab and temozolomide and radiotherapy by the same oncologist. Statistical analysis was performed using SPSS.

Results The mean overall survival (OS) in this study was 37.4 ± 13.6 months and the mean progression free survival (PFS) was 35.1 ± 9.8 months. The mean time to progression was 15.2 ± 8.79 months among 8 patients who experienced progression in this series. Finding of a positive CSF cytology was not linked with disease progression, while HIV infection and multifocal involvement at initial presentation were strongly linked to a lower PFS. The single most important factor affecting the OS was the histopathologic type of the PCNSL; two of the three patients who died from their disease in this series had non-B cell PCNSL, whereas only one patient with DLBCL died because of brainstem involvement.

Conclusion The results of this study show a lower rate of HIV-infection in patients with PCNSL as compared to the series from the western countries. Non-B cell histopathology and HIV-infection were found to be associated with the dismal prognosis.

Keywords

brain tumor - HIV - lymphoma - primary CNS lymphoma


Publication History

Article published online:
27 March 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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