ArticleNeuro-oncology2024
Outcomes and relapse patterns in primary central nervous system lymphoma: Longitudinal analysis of 559 patients diagnosed from 1983 to 2020.
Article in Neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Safety and efficacy of CAR T-cell therapy in central nervous system lymphoma: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- IGNITE: a phase III study of tirabrutinib versus rituximab and temozolomide combination therapy in relapsed/refractory primary central nervous system lymphoma.Future oncology (London, England) · 2026Trial
- Associations Between Early Neurosurgical Workflow and Survival in Primary Central Nervous System Lymphoma: A Single-Center Retrospective Study.Current oncology (Toronto, Ont.) · 2026Article
- Superiority of high-dose cytarabine-based mobilisation over cyclophosphamide or plerixafor in primary CNS lymphoma.Annals of hematology · 2026Article
- Patterns, risk factors and management of CD19-directed chimeric antigen receptor T-cell therapy failure in CNS lymphoma.Journal of hematology & oncology · 2026Article
- Case Report: Cerebellar ALK+ ALCL: diagnostic challenges and therapeutic innovation.Frontiers in oncology · 2026Article
- Consolidation Regimen and Cerebral Atrophy in Patients With Primary Central Nervous System Lymphoma.International journal of radiation oncology, biology, physics · 2025Article
- Comparison of outcomes in postinduction strategies for primary central nervous system lymphoma: a Mayo Clinic experience.Blood advances · 2025Article
- Urgent and emergent radiotherapy for hematologic malignancies of the central nervous system: a review of the literature and practical approach.Frontiers in oncology · 2025Review
- The contemporary spectrum of radiotherapy for hematologic malignancies involving the central nervous system: From focal therapy to craniospinal.Seminars in radiation oncology · 2025Review
- Evolving consolidation patterns and outcomes for a large cohort of patients with primary CNS lymphoma.Blood advances · 2024Article
- Primary central nervous system lymphoma: Predictors of response to induction therapy and patterns of progression.Neuro-oncology advancesArticle
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Authors and funding
11 authors.
Funding
Abstract
backgroundContemporary outcomes and relapse patterns in primary CNS lymphoma (PCNSL) are lacking. We analyzed factors associated with relapse in a large cohort with extensive follow-up.
methodsT1-post-contrast-enhancing disease was characterized in immunocompetent PCNSL (diffuse large B-cell) patients from 1983 to 2020. Patients were stratified by response to induction and consolidation (complete/unconfirmed [CR/CRu], partial, stable, progression [POD]). Refractory was POD during (or relapse ≤3 months of) induction. Initial relapse site was categorized as local (involving/adjacent to baseline), distant intraparenchymal, leptomeningeal, or other. Progression-free (PFS) and overall survival (OS) were assessed with proportional hazards. Cumulative incidence with competing risks was used to assess local relapse.
resultsMedian follow-up was 7.4 years (N = 559). Most (321, 57%) were recursive partitioning analysis class 2 (age ≥50, Karnosfky Performance Status [KPS] ≥70). Most had supratentorial (420, 81%), multifocal (274, 53%), bilateral (224, 43%), and deep structure involvement (314, 56%). Nearly all received methotrexate-based induction (532, 95%). There was no difference in PFS or OS from consolidation based on initial response to induction (CR/CRu vs PR) in patients who ultimately achieved a CR/CRu to consolidation. PFS at 1-, 5 years for 351 patients with CR/CRu to consolidation was 80% (95% confidence interval [95% CI]: 76%-84%) and 46% (95% CI: 41%-53%), respectively; 1-year cumulative incidence of local versus nonlocal relapse was 1.8% versus 15%, respectively. For 97 refractory patients, 1-year cumulative incidence of local versus nonlocal relapse was 57% versus 42%, respectively. Deep structure involvement (HR 1.89, 95% CI: 1.10%-3.27%) was associated with local relapse in refractory patients.
conclusionsWe report the first comprehensive relapse patterns in a large PCNSL cohort. While relapses post-CR to consolidation are typically distant and unpredictable, refractory patients had a relatively high incidence of local relapse. These findings can help optimize multimodality therapy for this highest-risk population.
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