Clinical characteristics and prognosis of 20 cases of primary central nervous system lymphoma

Abstract

This study was to investigate the clinical and pathological characteristics, curative effect and prognosis of primary central nervous system lymphoma (PCNSL). The clinical and pathological features, diagnosis and treatment, curative efficacy and survival rate of 20 cases of primary central nervous system lymphoma were retrospectivaly analyzed. The indicated that the clinical manifestations included headache, paralysis, seizures, dizziness and mental acuity, etc. There were 7 cases with single focus of lesion, 13 cases with multiple foci of lesions. The pathologic examimation showed 1 case of peripheral T-cell lymphoma and 19 cases of diffuse large B cell lymphoma, they all were from non-germinal center. Out of 20 cases, 11 cases with Ki-67>75%,6 cases with Ki-67 50%-75%, 2 cases with Ki-67 25%-50% and 1 case with Ki-67 10%. Therapeutic evaluation were as follows: 10 cases with CR, 2 cases with PR, 6 cases with PD in 18 patients recieved treatment. The use of ritusimab in treatment or no use and number of lesion foci in cranium were related to survival time (P < 0.05) . The survival time in group with Ki-67(+)<75% was longer than that in group with Ki-67(+)>75% (P = 0.042). Age and CSF-TP level were related to curative effect (P < 0.05) . There is no specific clinical manifestation. The physical examination and imageological diagnosis of PCNSL, as well as pathological biopsy are necessary for diagnose of PCNSL. The factors for poor prognosis include age > 60 years, CSF-TP > 600 mg/L, multiple lesions and Ki-67(+)>75%. PCNSL has high malignancy and poor prognosis. The chemotherapy based on high dose of MTX (among which MTX combined with rituximab) and HSCT after CR are the best treatment regimen for DLBCL.