Skip to main content

Advertisement

SpringerLink
Log in

Survival among patients with primary central nervous system lymphoma, 1973–2004

  • Clinical Study - Patient Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Primary central nervous system lymphoma (PCNSL) is a rare non-Hodgkin’s lymphoma that occurs in immunocompetent and human immunodeficiency virus (HIV) patients. Despite treatment advances, previous reports have produced conflicting information about survival trends over time. Using the Surveillance, Epidemiology, and End Results (SEER) data, 2,557 patients diagnosed with PCNSL between 1973 and 2004 were identified and classified by HIV status. Potential predictors of survival were evaluated using log-rank tests. Hazard ratios and 95% confidence intervals (CIs) were computed using a Cox proportional hazards regression model. The cohort included 1,732 (67.7%) HIV-negative patients and 825 (32.3%) HIV-positive patients. Median overall survival was 12 months (95% CI 10, 13) among HIV-negative patients. In this group, median survival increased over time, from 7.5 months (95% CI 6, 14) for patients diagnosed in the 1970s, to 14 months (95% CI 11, 20) for patients diagnosed in the 2000s. Independent predictors of mortality included older age (hazard ratio [HR] 1.03 [95% CI 1.02, 1.03]), earlier year of diagnosis (HR 0.98 [95% CI 0.98, 0.99]), male sex (HR 1.20 [95% CI 1.08, 1.34), married status (HR 0.70 [95% CI 0.63, 0.78]), and receipt of radiation therapy (HR 0.69 [95% CI 0.61, 0.77]). HIV positivity was a powerful adverse prognostic factor in the overall cohort (HR 4.55 [95% CI 4.01, 5.16]). Despite treatment advances, survival among PCNSL patients in the United States remains poor. However, in the subset of PCNSL patients who are HIV-negative, survival has improved over time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. CBTRUS (2008) Statistical report: primary brain tumors in the United States, 2000–2004. Published by the Central Brain Tumor Registry of the United States

  2. Hoffman S, Propp JM, McCarthy BJ (2006) Temporal trends in incidence of primary brain tumors in the United States, 1985–1999. Neuro Oncol 8:27–37

    Article  PubMed  Google Scholar 

  3. Abrey LE (2009) Primary central nervous system lymphoma. Curr Opin Neurol, 2009 [Epub ahead of print]

  4. Nelson DF, Martz KL, Bonner H, Nelson JS, Newall J, Kerman HD, Thomson JW, Murray KJ (1992) Non-Hodgkin’s lymphoma of the brain: can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation Therapy Oncology Group (RTOG): RTOG 8315. Int J Radiat Oncol Biol Phys 23:9–17

    Article  CAS  PubMed  Google Scholar 

  5. Abrey LE, Correa DD (2005) Treatment-related neurotoxicity. Hematol Oncol Clin North Am 19:729–738 viii

    Article  PubMed  Google Scholar 

  6. Morris PG, Abrey LE (2009) Therapeutic challenges in primary CNS lymphoma. Lancet Neurol 8:581–592

    Article  CAS  PubMed  Google Scholar 

  7. Panageas KS, Elkin EB, Ben-Porat L, Deangelis LM, Abrey LE (2007) Patterns of treatment in older adults with primary central nervous system lymphoma. Cancer 110:1338–1344

    Article  PubMed  Google Scholar 

  8. Abrey LE, Panageas KS (2006) Identifying and addressing barriers to the delivery of optimal therapy for primary central nervous system lymphoma in the broader community. Leuk Lymphoma 47:2449–2452

    Article  PubMed  Google Scholar 

  9. Panageas KS, Elkin EB, DeAngelis LM, Ben-Porat L, Abrey LE (2005) Trends in survival from primary central nervous system lymphoma, 1975–1999: a population-based analysis. Cancer 104:2466–2472

    Article  PubMed  Google Scholar 

  10. Shenkier TN, Voss N, Chhanabhai M, Fairey R, Gascoyne RD, Hoskins P, Klasa R, Morris J, O’Reilly SE, Pickles T, Sehn L, Connors JM (2005) The treatment of primary central nervous system lymphoma in 122 immunocompetent patients: a population-based study of successively treated cohorts from the British Colombia Cancer Agency. Cancer 103:1008–1017

    Article  PubMed  Google Scholar 

  11. Haldorsen IS, Krossnes BK, Aarseth JH, Scheie D, Johannesen TB, Mella O, Espeland A (2007) Increasing incidence and continued dismal outcome of primary central nervous system lymphoma in Norway 1989–2003 : time trends in a 15-year national survey. Cancer 110:1803–1814

    Article  PubMed  Google Scholar 

  12. Shibamoto Y, Ogino H, Suzuki G, Takemoto M, Araki N, Isobe K, Tsuchida E, Nakamura K, Kenjo M, Suzuki K, Hosono M, Tokumaru S, Ishihara S, Kato E, Ii N, Hayabuchi N (2008) Primary central nervous system lymphoma in Japan: changes in clinical features, treatment, and prognosis during 1985–2004. Neuro Oncol 10:560–568

    Article  PubMed  Google Scholar 

  13. Kreisl TN, Panageas KS, Elkin EB, Deangelis LM, Abrey LE (2008) Treatment patterns and prognosis in patients with human immunodeficiency virus and primary central system lymphoma. Leuk Lymphoma 49:1710–1716

    Article  CAS  PubMed  Google Scholar 

  14. Cox DR (1972) Regression models and life tables. J R Stat Soc[B] 34:187–202

    Google Scholar 

  15. Goodwin JS, Hunt WC, Key CR, Samet JM (1987) The effect of marital status on stage, treatment, and survival of cancer patients. JAMA 258:3125–3130

    Article  CAS  PubMed  Google Scholar 

  16. Chang SM, Barker FG II (2005) Marital status, treatment, and survival in patients with glioblastoma multiforme: a population based study. Cancer 104:1975–1984

    Article  PubMed  Google Scholar 

  17. Ferreri AJ, Dell’Oro S, Foppoli M, Bernardi M, Brandes AA, Tosoni A, Montanari M, Balzarotti M, Spina M, Ilariucci F, Zaja F, Stelitano C, Bobbio F, Corazzelli G, Baldini L, Ponzoni M, Picozzi P, Caligaris Cappio F, Reni M (2006) MATILDE regimen followed by radiotherapy is an active strategy against primary CNS lymphomas. Neurology 66:1435–1438

    Article  CAS  PubMed  Google Scholar 

  18. Hoang-Xuan K, Taillandier L, Chinot O, Soubeyran P, Bogdhan U, Hildebrand J, Frenay M, De Beule N, Delattre JY, Baron B (2003) Chemotherapy alone as initial treatment for primary CNS lymphoma in patients older than 60 years: a multicenter phase II study (26952) of the European Organization for Research and Treatment of Cancer Brain Tumor Group. J Clin Oncol 21:2726–2731

    Article  CAS  PubMed  Google Scholar 

  19. Zhu JJ, Gerstner ER, Engler DA, Mrugala MM, Nugent W, Nierenberg K, Hochberg FH, Betensky RA, Batchelor TT (2009) High-dose methotrexate for elderly patients with primary CNS lymphoma. Neuro Oncol 11:211–215

    Article  CAS  PubMed  Google Scholar 

  20. Shah GD, Yahalom J, Correa DD, Lai RK, Raizer JJ, Schiff D, LaRocca R, Grant B, DeAngelis LM, Abrey LE (2007) Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 25:4730–4735

    Article  CAS  PubMed  Google Scholar 

  21. Pulido JS, Vierkant RA, Olson JE, Abrey L, Schiff D, O’Neill BP (2009) Racial differences in primary central nervous system lymphoma incidence and survival rates. Neuro Oncol 11:318–322

    Article  PubMed  Google Scholar 

  22. Diamond C, Taylor TH, Im T, Wallace M, Saven A, Anton-Culver H (2007) How valid is using cancer registries’ data to identify acquired immunodeficiency syndrome-related non-Hodgkin’s lymphoma? Cancer Causes Control 18:135–142

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Neuro-Oncology, Dana-Farber/Brigham and Women’s Cancer Center, 44 Binney St, Boston, MA, 02115, USA

    Andrew D. Norden, Jan Drappatz & Patrick Y. Wen

  2. Division of Neuro-Oncology, Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA

    Andrew D. Norden, Jan Drappatz & Patrick Y. Wen

  3. Harvard Medical School, Boston, MA, USA

    Andrew D. Norden, Jan Drappatz, Patrick Y. Wen & Elizabeth B. Claus

  4. Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA, USA

    Elizabeth B. Claus

  5. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA

    Elizabeth B. Claus

Authors
  1. Andrew D. Norden
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Drappatz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick Y. Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elizabeth B. Claus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew D. Norden.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Norden, A.D., Drappatz, J., Wen, P.Y. et al. Survival among patients with primary central nervous system lymphoma, 1973–2004. J Neurooncol 101, 487–493 (2011). https://doi.org/10.1007/s11060-010-0269-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-010-0269-7

Keywords

Search

Navigation