Vnitr Lek 2012, 58(12):915-921

Our experience with the treatment of primary lymphomas of the central nervous system

M. Motyčková^*, L. Smolej, D. Belada, J. Malý, P. Žák

IV. interní hematologická klinika Lékařské fakulty UK a FN Hradec Králové, přednosta doc. MUDr. Pavel Žák, Ph.D.

Introduction:
The aim of this study was to assess treatment efficiency, overall survival (OS) and identify risk factors with the influence on patients prognosis in patients with primary central nervous system lymphomas (PCNSL) who were treated with intensive chemotherapy based on high-dose methotrexate and cytosin-arabinoside followed by whole-brain radiotherapy (MPV regimen).

Patients and methods:
From January 1998 to February 2011, 39 patients with PCNSL were diagnosed on our department. The median from the first clinical symptomatology to histological diagnosis was 4 weeks (range, 2-19). Thirty-seven patients were treated with MPV regimen.

Results:
The therapeutic response was evaluated in 35 patients (2 patients died early during treatment). The overall response/complete remission rate was 63/60%. At the time of analysis (november 2011), the median of follow-up was 16,5 months; 31 patients died (the most often causes of death were poor treatment effect and treatment complications). The 2-year OS was 30% and median PFS and OS were 9 and 12 months. Patients with WHO performance status 0-1 and those with normal serum lactate dehydrogenase serum had significantly longer OS (p = 0.0495 and p = 0.0232).

Conclusion:
The treatment results of our patients appear to be inferior than data from literature. The reason is probably high occurrence of negative prognostic factors. Early diagnosis and intensive treatment are crucial for improvement of prognosis.

Keywords: primary central nervous system lymphoma; chemotherapy; radiotherapy; methotrexate; risk factors; overall survival

Received: June 11, 2012; Accepted: October 3, 2012; Published: December 1, 2012  Show citation