Evidence map›Paper›PMID 38865013›Full record

ArticleJournal of neuro-oncology2024

Primary central nervous system lymphomas in immunocompromised patients require specific response criteria.

Nina Schulz, Lucia Nichelli, Laurence Schenone, Renata Ursu, Julie Abraham, Marie Le Cann, Véronique Morel, Inès Boussen, Dario Herran, Delphine Leclercq and 6 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Nina SchulzDepartment of Neurooncology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Inserm, CNRS, UMR S 1127, ICM, IHU, Paris, France. nina.u.schulz@gmail.com.
Lucia NichelliDepartment of Neuroradiology, APHP Sorbonne Université, IHU, ICM, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Laurence SchenoneDepartment of Neurooncology, CHRU de Nancy, Hôpital Central, Nancy, France.
Renata UrsuDepartment of Neurology, AP-HP Nord, Université de Paris Cité, Saint-Louis Hospital, AP-HP, Paris, France.
Julie AbrahamDepartment of Hematology, CHU de Limoges, Limoges, France.
Marie Le CannDepartment of Hematology, Université Paris-SaclayHopital Bicêtre, Le Kremlin-Bicêtre, Paris, France.
Véronique MorelDepartment of Clinical Hematology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Inès BoussenDepartment of Clinical Hematology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Dario HerranDepartment of Neuroradiology, APHP Sorbonne Université, IHU, ICM, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Delphine LeclercqDepartment of Neuroradiology, APHP Sorbonne Université, IHU, ICM, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Marie BlonskiDepartment of Neurooncology, CHRU de Nancy, Hôpital Central, Nancy, France.
Bertrand MathonDepartment of Neurosurgery, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Khê Hoang-XuanDepartment of Neurooncology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Inserm, CNRS, UMR S 1127, ICM, IHU, Paris, France.
Carole SoussainDepartment of Clinical Hematology, Institut Curie, Saint Cloud, Paris, France.
Sylvain ChoquetDepartment of Clinical Hematology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Caroline HouillierDepartment of Neurooncology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Inserm, CNRS, UMR S 1127, ICM, IHU, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeImmunosuppression is a well-established risk factor for primary central nervous system lymphomas (PCNSLs), which present in this context distinct radiological characteristics. Our aim was to describe the radiological evolution of treated PCNSL in immunocompromised patients and suggest adapted MRI response criteria.

methodsWe conducted a multicenter retrospective study of patients from the French LOC, K-Virogref and CANCERVIH network databases and enrolled adult immunocompromised patients with newly diagnosed PCNSL.

resultsWe evaluated the baseline, intermediate, end-of-treatment and follow-up MRI data of 31 patients (9 living with HIV, 16 with solid organ transplantation and 6 with an autoimmune disease under chronic immunosuppressive therapy). At baseline, 23/30 (77%) patients had necrotic lesions with ring enhancement and 28% of the lesions were hemorrhagic. At the end of the first-line treatment, 12/28 (43%) patients could not be classified according to the IPCG criteria. Thirteen of 28 (46%) patients still harbored contrast enhancement, and 11/28 (39%) patients had persistent large necrotic lesions with a median diameter of 15 mm. These aspects were not associated with a pejorative outcome and progressively diminished during follow-up. Six patients relapsed; however, we failed to identify any neuroimaging risk factors on the end-of-treatment MRI.

conclusionIn immunocompromised patients, PCNSLs often harbor alarming features on end-of-treatment MRI, with persistent contrast-enhanced lesions frequently observed. However, these aspects seemed to be related to the necrotic and hemorrhagic nature of the lesions and were not predictive of a pejorative outcome. Specific response criteria for this population are thereby proposed.

Indexed as

Central Nervous System NeoplasmsImmunocompromised HostLymphomaMagnetic Resonance ImagingAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesHIVImmunodepressionMRIPrimary central nervous system lymphomaResponse criteriaSolid organ transplantation

Identifiers

PMID38865013

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.