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Primary B-cell CNS lymphoma clinicopathologic and treatment outcomes in 89 patients from a single tertiary care center

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Abstract

Primary central nervous system lymphoma (PCNSL) is a rare aggressive variant of diffuse large B-cell lymphoma with a poor prognosis and no defined optimal therapeutic strategies. Our aim was to compare the role of intrathecal chemotherapy with current high-dose methotrexate (HDMTX) treatments. Clinicopathologic characteristics, therapy, and outcomes of patients with PCNSL at Moffitt Cancer Center were reviewed in 89 patients identified over an 11-year period. Patients treated initially with HDMTX-based therapy showed improved overall and progression-free survival, with no improvement shown with added radiation or intrathecal therapy. Age and performance status were also important prognostic indicators. Our conclusion is that initial therapy in PCNSL should include an HDMTX backbone. The use of intrathecal chemotherapy or radiation therapy initially likely does not improve outcomes. Future multicenter phase III clinical trials are needed to better establish the superior initial treatment in PCNSL.

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Acknowledgments

We thank Rasa Hamilton (Moffitt Cancer Center) for editorial assistance.

Conflict of interest

None of the authors have any conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, and the University of South Florida, 12902 Magnolia Drive, Tampa, FL, 33602, USA

    Samir Dalia, Julio Chavez, Bijal Shah, Celeste Bello, Lubomir Sokol, Eduardo Sotomayor & Michael Jaglal

  2. Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Peter Forsyth

  3. Department of Pharmacy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Samantha Price

  4. Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA

    Edward Pan

  5. Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Ji-Hyun Lee & Kate Fisher

Authors
  1. Samir Dalia
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  2. Peter Forsyth
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  3. Julio Chavez
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  10. Ji-Hyun Lee
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  11. Kate Fisher
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Correspondence to Samir Dalia.

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Dalia, S., Forsyth, P., Chavez, J. et al. Primary B-cell CNS lymphoma clinicopathologic and treatment outcomes in 89 patients from a single tertiary care center. Int J Hematol 99, 450–456 (2014). https://doi.org/10.1007/s12185-014-1540-z

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  • DOI: https://doi.org/10.1007/s12185-014-1540-z

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