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. 2019 Jul 5;10(17):3958-3966.
doi: 10.7150/jca.32467. eCollection 2019.

Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Chia-Hsin Lin  1   2 , Ching-Fen Yang  3 , Huai-Che Yang  4   5 , Li-Yu Fay  4 , Chiu-Mei Yeh  6   7 , Ai-Seon Kuan  8 , Hao-Yuan Wang  2   6 , Jyh-Pyng Gau  2   6 , Liang-Tsai Hsiao  2   6 , Tzeon-Jye Chiou  2   9 , Po-Min Chen  2   6 , Yao-Chung Liu  2   6 , Po-Shen Ko  2   6 , Jin-Hwang Liu  6   10   11 , Chia-Jen Liu  6   7
Affiliations

Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Chia-Hsin Lin et al. J Cancer. .

Abstract

Background: Overall survival of patients with primary CNS lymphoma (PCNSL) has improved since the introduction of immunochemotherapy. However, up to 10-15% of PCNSL patients still die shortly after diagnosis. In the present study, we aimed to investigate the risk factors of early mortality (death within 60 days after diagnosis) in patients with PCNSL. Methods: We included newly diagnosed PCNSL patients in a tertiary medical center in Taiwan between January 1, 2002 and May 31, 2018. Clinical risk factors were collected and compared between PCNSL patients who had and did not have early mortality. Results: A total of 133 consecutive patients with PCNSL were included in this study. Approximately 9.8% of the PCNSL patients had early mortality. In multivariate analysis, age ≥ 80 (adjusted hazard ratio [HR] 3.34, 95% confidence interval [CI] 1.01-11.04, p = 0.048) and involvement of the basal ganglia (adjusted HR 4.85, 95% CI 1.47-15.95, p = 0.009) were identified as independent risk factors of early mortality. Use of MTX-based chemotherapy served as an independent protective factor for early mortality (adjusted HR 0.19, 95% CI 0.05-0.67, p = 0.010). Infection and tumor-associated mass effect contributed most to early mortality. Conclusion: Early mortality is not uncommon in patients with PCNSL. Identification of patients with higher risk may help clinicians with initiating appropriate surveillance and management.

Keywords: Early mortality; epidemiology; primary CNS lymphoma; prognostic factors.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
The flow chart for this study
Figure 2
Figure 2
Treatment in the 133 primary CNS lymphoma patients studied. MTX, methotrexate; HD, high dose; CHOP, cyclophosphamide, doxorubine, vincristine, prednisone.
Figure 3
Figure 3
Survival probability of PCNSL patients
Figure 4
Figure 4
Contributing causes of early mortality (percentage of all mortality)
See this image and copyright information in PMC

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