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KMID : 0366220170520040285
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Korean Journal of Hematology
2017 Volume.52 No. 4 p.285 ~ p.292
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Primary central nervous system lymphoma: a new prognostic model for patients with diffuse large B-cell histology
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Ahn Yong-Chel
Ahn Heui-June
Yoon Dok-Hyun
Hong Jung-Yong
Yoo Chang-Hoon
Kim Shin
Huh Joo-Ryung
Suh Cheol-Won
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Abstract
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Background: Age and performance status are important prognostic factors in primary central nervous system (CNS) lymphoma. Although several prognostic models have been proposed, there is no consensus on the optimal model for patients with diffuse large B-cell histology.
Methods: Seventy-seven patients with primary CNS diffuse large B-cell lymphoma were retro-spectively analyzed to determine factors affecting survival. Three Western models were applied to our eligible patients; we devised a novel model based on our findings.
Results: The median patient age was 59 years (range, 29?77); the median event-free and overall survival (OS) durations were 35.9 and 12.6 months, respectively. Nottingham/Barcelona and Memorial Sloan Kettering Cancer Center models were applicable to our cohorts. Multivariate analysis showed that advanced age, multifocal lesions, and high cere-brospinal fluid (CSF) protein concentrations were correlated significantly. A novel model for predicting prognosis was then developed based on these variables. Each variable was assigned 1 point; patients with a total score of 0, 1, 2, and 3 were categorized into the low- (N=17), moderate- (N=26), high- (N=14), and very high-risk groups (N=4), respectively. Sixty-one patients were eligible considering our model; the median OS was 58.2, 34.8, 9.0, and 1.8 months in the low-, moderate-, high-, and very high-risk groups, respectively (P＜0.01).
Conclusion: Advanced age, multifocal lesions, and high CSF protein concentration were adversely related with prognosis. Our model can be helpful in pre-treatment risk stratification for patients with primary CNS lymphoma with diffuse large B-cell histology.
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KEYWORD
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Central nervous system, Lymphoma, Prognosis, Survival
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