Primary Central Nervous System Lymphoma, Treatment Outcomes - 10 Year Experience. Single Center Study

Ajla Nizic; Lejla Ibricevic-Balic; Timur Ceric; Ibrahim Omerhodzic; Lejla Burazerovic; Vasvija Saric; Emina Mameledzija; Berina Hasanefendic

doi:10.5455/msm.2024.36.23-25

Primary Central Nervous System Lymphoma, Treatment Outcomes - 10 Year Experience. Single Center Study

Mater Sociomed. 2024;36(1):23-25. doi: 10.5455/msm.2024.36.23-25.

Authors

Ajla Nizic¹, Lejla Ibricevic-Balic², Timur Ceric³, Ibrahim Omerhodzic⁴, Lejla Burazerovic², Vasvija Saric², Emina Mameledzija⁵, Berina Hasanefendic^{6

7}

Affiliations

¹ Primary Health Care Center "JU Dom zdravlja Kantona Sarajevo".
² Haematology Clinic, Clinical center University of Sarajevo.
³ Oncology Clinic, Clinical Center University of Sarajevo.
⁴ Neurosurgery Clinic, Clinical center University of Sarajevo.
⁵ Pathology Department, Medical Faculty, University of Sarajevo.
⁶ Clinical Biochemistry and Immunology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
⁷ Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.

Abstract

Background: Primary central nervous system lymphoma(PCNSL) is an aggressive, rare form of Non-Hodgkin lymphoma, characterized by the absence of systemic disease. There are limited data and no strictly defined guidelines for management of PCNSL.

Objective: The aim of this study was to report a 10 year experience of PCNSL treatment, to evaluate treatment outcomes and asses Progression Free and Overall Survival of these patients.

Methods: Study was conducted on the Haematology Clinic, Clinical center University of Sarajevo, BH, in the period from January 2012.-December 2022. Total sample of 24 patients were enrolled. All have undergone diagnostic surgery. Patients were treated with regimens based on High dose Methotrexate, with/without whole brain radiotherapy as consolidation. Treatment response was captured by imaging techniques. Patients who have relapsed were evaluated with imaging techniques and treated according to Methotrexate-based treatment protocols.

Results: We have captured equal gender distribution. The median age of patients was 59.5 years (range 20-79). Pathohistological analysis confirmed DLBCL diagnosis in 22 patients, T cell lymphoma and anaplastic large cell lymphoma, each in 1 patient. Chemotherapy, chemotherapy combined with WBRT and radiotherapy were given to 5, 18 and 1 patients, respectively. The overall complete response rate (CR) was 87,15%. Those receiving combined modality-treatment had higher CR than those receiving chemotherapy (94,4% versus 60%). Out of 24 patients, 11 of them relapsed. The median time to relapse was 29 months (from 1 to 105). After second line of the treatment, CR was 54,5%, while 45,45% of patients died during the treatment. 4 patients relapsed for the second time with median time to relapse of 9 months (from 2 to 77). 2 year OS rate was 67%, and the median OS rate was 45,9 months. 2 year PFS rate was 31%.

Conclusion: The OS and PFS rates indicate the usage of new drugs and consolidation with autologous stem cell transplantation in patients with PCNSL in order to achieve better treatment outcomes.

Keywords: High dose Methotrexate; PCNSL; treatment outcomes.