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

Asian Journal of Neurosurgery, 2023 · DOI: https://doi.org/10.1055/s-0043-1761229 · Published: March 27, 2023

Simple Explanation

Primary central nervous system lymphoma (PCNSL) is a rare type of non-Hodgkin's lymphoma that affects the brain and spinal cord. This study presents the experience of managing PCNSL in a tertiary care center in Iran. The study found that HIV infection and multiple lesions at the initial presentation were associated with lower progression-free survival. The histopathologic type of PCNSL was the most important factor affecting overall survival. The results also suggest that HIV infection is less common in PCNSL patients in Iran compared to Western countries. Non-B cell histopathology and HIV-infection were found to be associated with a worse prognosis.

Study Duration

January 2011 to December 2018

Participants

58 patients with tissue diagnosis of PCNSL

Evidence Level

Retrospective study

Key Findings

1
The mean overall survival was 37.4 months, and the mean progression-free survival was 35.1 months.
2
HIV infection and multifocal involvement at initial presentation were strongly linked to a lower progression-free survival.
3
The histopathologic type of PCNSL was the single most important factor affecting overall survival. Patients with non-B cell PCNSL had a worse prognosis.

Research Summary

This retrospective study analyzed 58 patients with PCNSL treated at a tertiary care center in Iran between 2011 and 2018. The study aimed to identify prognostic factors affecting survival and disease progression. The most common histological finding was diffuse large B-cell lymphoma (DLBCL) in 96.5% of patients. HIV infection was detected in 5.1% of patients. The study concluded that HIV infection is less common in PCNSL patients in Iran compared to Western countries. Non-B cell histopathology and HIV infection were associated with dismal prognosis.

Practical Implications

Treatment Strategies

The study highlights the importance of considering HIV status and histopathologic type in treatment planning for PCNSL patients.

Prognostic Markers

Multifocal involvement at initial presentation can serve as a prognostic marker for lower progression-free survival.

Regional Differences

The lower rate of HIV infection among PCNSL patients in the Middle East compared to Western countries suggests potential regional differences in disease etiology or patient populations.

Study Limitations

1
Retrospective study design
2
Limited number of patients, especially those with HIV infection, positive CSF cytology, and multifocal lesions
3
Comparisons need to be proved in larger studies from similar populations

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