Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Moench, A.
Distinct clinical, serological and histopathological parameters are associated with inferior survival of patients with primary central nervous system lymphoma
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 99
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Deutsch Alexander
- Uhl Barbara
- Altmetrics:
- Abstract:
- Background: Primary central nervous system lymphoma (PCNSL) is an aggressive and rare extranodal subtype of Diffuse Large B‐Cell Lymphoma (DLBCL), representing approximately 4% of all newly diagnosed brain tumors. Because of the development of novel therapeutic protocols, the two most commonly used prognostic scoring systems, the International Extranodal Lymphoma Study Group (IELSG) score and Memorial Sloan-Kettering Cancer Center (MSKCC) score need to be updated to improve the risk stratification of these patients. Thus, we aimed on verifying already established prognostic markers and on identifying new prognostic markers in PCNSL. Material and Methods: We included 74 newly diagnosed PCNSL patients in our study, wherefrom 69 received therapy. The median age of our study group was 63 years and the distribution of gender was as follows: 59.5% (n=44) male and 40.5% (n=30) female patients. Our primary endpoint was the overall survival (OS) and we used univariate analyses to determine clinical, serological and histopathological parameters associated with OS. The data we used were collected from patients prior to treatment. Results: In our cohort we observed the clinical usefulness of the MSKCC score in association with inferior OS (p=0.01). However, we could not use the IELSG score because we largely lacked liquor samples. By further investigation, we detected that the brain as primary manifestation site (p=0.013), advanced age (>60years, p=0.009) and progression of disease within 12 or 24 months (p<0.0001) were correlated with reduced OS. Furthermore, the following serum factors: leukocytosis (>11.3G/l, p=0.013), neutrophilia (>7.7G/l, p=0.0175), high systemic immune inflammation index (p= 0.0044), high GGT (>55U/l, p=0.037), hypoalbuminemia (<3.5g/dl, 0.0048), hypoproteinemia (<6.6g/dl, <0.0001), high neutrophil-to-lymphocyte ratio (NLR, p=0.003), high derived NLR (p=0.0009) and high LDH-to-lymphocyte ratio (p=0.048) were associated with a poor clinical outcome. Finally, we found an association of the germinal center subtype (p=0.046), the double expressor lymphoma status (p=0.003), the lack of CD30 expression (p=0.013) as well as the lack of GCET-1 expression (p=0.0386) with inferior OS in our patients. Discussion: Our data indicate that the above listed parameters are associated with OS in PCNSL patients. Thus, these factors represent promising tools to develop a more effective prognostic model for risk stratification and that is why we are planning to perform multivariate analysis to strengthen our results.