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Duan Y, Gao H, Zhou C, Jin L, Yang J, Huang S, Zhang N, Zhang M, Yang X, Zhang Y, Wang T. Primary central nervous system lymphoma in children - a rare but serious disease with good prognosis from a single center in China. Leuk Lymphoma 2023; 64:2327-2332. [PMID: 37919839 DOI: 10.1080/10428194.2023.2263120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Yanlong Duan
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Huixia Gao
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Chunju Zhou
- Pathology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ling Jin
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Jing Yang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Shuang Huang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Ningning Zhang
- Radiology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Meng Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Xueliang Yang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Yonghong Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
| | - Tianyou Wang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health; Beijing Key Laboratory of Pediatric Hematology Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics, Capital Medical University, Beijing, China
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Chen X, Huang M, Zhang Z, Jing H, Zou Y, Bu H. Primary meningeal central nervous system lymphoma: A case report and literature review. Medicine (Baltimore) 2022; 101:e32567. [PMID: 36596043 PMCID: PMC9803511 DOI: 10.1097/md.0000000000032567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
RATIONALE Primary central nervous system lymphoma (PCNSL) is a rare extranodal non-Hodgkin lymphoma, and isolated meningeal PCNSL, without evidence of parenchymal involvement, is even less common, occurring in only 10% to 15% of cases. PATIENT CONCERNS A 65-years-old female presented to our hospital with progressive lower extremity motor dysfunction and blurred vision. The initial neurological examination revealed decreased muscle strength in both lower extremities and sensory dysfunction of lower extremities, saddle area, and buttocks. Brain magnetic resonance imaging showed no abnormalities. Lumbar enhanced magnetic resonance imaging showed T11 to L3 horizontal meningeal enhancement. Cerebrospinal fluid (CSF) cytology revealed lymphoma cells. Immunohistochemistry and flow cytometry of the CSF were performed as auxiliary methods to establish the diagnosis of lymphoma. DIAGNOSES The patient was diagnosed primary meningeal central nervous system lymphoma. INTERVENTIONS During hospitalization, the patient was treated with 2 courses of high-dose intrathecal methotrexate and rituximab combined with intrathecal chemotherapy and supportive treatment. OUTCOMES After 2 years of follow-up, the patient was able to walk and take care of herself. LESSONS Cases of PCNSL involving only the meninges are rare. Multimodal analysis of the CSF comprises an important component of the diagnostic work-up for patients with primary meningeal central nervous system lymphoma.
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Affiliation(s)
- Xue Chen
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Min Huang
- Department of Neurology, Yuncheng Central Hospital of Shanxi Province, Shanxi, China
| | - Zhenyuan Zhang
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huilan Jing
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yueli Zou
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hui Bu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- * Correspondence: Hui Bu, Department of Neurology, The Second Hospital of Hebei Medical University, 215 Heping West Road, Shijiazhuang, Hebei 050000, China (e-mail: )
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Tang Y, Shi Y, Wang L, Qian ZT, Fan YW, Wu HM, Li X. Preliminary clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy in the diagnosis of primary central nervous system lymphoma. Heliyon 2022; 8:e12162. [DOI: 10.1016/j.heliyon.2022.e12162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/06/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
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Huang H, Yang ZH, Gu ZW, Luo M, Xu L. Decision Tree Model for Predicting the Overall Survival of Patients with Diffused Large B-Cell Lymphoma in the Central Nervous System. World Neurosurg 2022; 166:e189-e198. [PMID: 35803570 DOI: 10.1016/j.wneu.2022.06.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To identify the significant predictors of overall survival for patients living with diffused large B-cell lymphoma (DLBCL) in the central nervous system and establish a novel decision tree model to help predict survival status at several time points. METHODS Patients diagnosed with DLBCL were identified from the SEER database and randomly divided into training and test samples (6:4). Dichotomous decision trees were developed for survival status at 3, 12, 24, and 60 months. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate, and area under the receiver operating characteristic curve were calculated to evaluate the model performance. RESULTS A total of 2998 patients were included, with 1799 and 1199 patients divided into the training and testing groups. Decision trees for 3, 12, 24, and 60 months survival status were generated. Chemotherapy and patient's age were of the primary importance for prognosis in the novel models. Favorable consistency between the predicted and actual survival status was presented. The accuracy rates were 0.79, 0.71, 0.68, and 0.86 for training sample at 3, 12, 24, and 60 months, respectively, and 0.75, 0.69, 0.58, and 0.84 for test sample at 3, 12, 24, and 60 months, respectively. The area under the receiver operating characteristic curve values ranged between 0.645 and 0.721 for the training sample and between 0.607 and 0.712 for the test sample. CONCLUSIONS Novel decision tree models were established for predicting the 3, 12, 24, and 60 months survival status of patients with DLBCL. The newly developed models were verified using training and test samples, showing favorable accuracy and predictive value on overall survival.
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Affiliation(s)
- Hua Huang
- Department of Neurosurgery, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China.
| | - Zhi-Hao Yang
- Department of Neurosurgery, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China
| | - Zhi-Wei Gu
- Department of Neurosurgery, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China
| | - Ming Luo
- Department of Neurosurgery, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China
| | - Lei Xu
- Department of Neurosurgery, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China
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Shao L, Xu C, Wu H, Jamal M, Pan S, Li S, Chen F, Yu D, Liu K, Wei Y. Recent Progress on Primary Central Nervous System Lymphoma-From Bench to Bedside. Front Oncol 2021; 11:689843. [PMID: 34485125 PMCID: PMC8416460 DOI: 10.3389/fonc.2021.689843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023] Open
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare subtype of extra-nodal lymphoma. The high relapse rate of PCNSL remains a major challenge to the hematologists, even though patients exhibit high sensitivity to the methotrexate-based chemotherapeutic regimens. Recently, the advent of Bruton's tyrosine kinase inhibitor (BTKi) and CAR T treatment has made more treatment options available to a proportion of patients. However, whether BTKi monotherapy should be given alone or in combination with conventional chemotherapy is still a clinical question. The status of CAR T therapy for PCNSLs also needs to be elucidated. In this review, we summarized the latest progress on the epidemiology, pathology, clinical manifestation, diagnosis, and treatment options for PCNSLs.
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Affiliation(s)
- Liang Shao
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chengshi Xu
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Huijing Wu
- Department of Lymphoma Medicine, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Muhammad Jamal
- Department of Immunology, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Shan Pan
- School of Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Sirui Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fei Chen
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ding Yu
- Department of Lymphoma Medicine, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kui Liu
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yongchang Wei
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Caputo M, Prencipe N, Bisceglia A, Bona C, Maccario M, Aimaretti G, Grottoli S, Gasco V. Primary Pituitary Lymphoma As Rare Cause Of A Pituitary Mass And Hypopituitarism In Adulthood. Endocr Pract 2021; 26:1337-1350. [PMID: 33471665 DOI: 10.4158/ep-2020-0286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Differential diagnosis of nonadenomatous sellar masses causing hypopituitarism is still a challenge. Among these masses, growing evidence has demonstrated that primary pituitary lymphoma is a specific and emerging entity. The aim of our study was to describe our experience with a case of primary pituitary lymphoma and to perform a review of the available literature. METHODS We searched relevant databases up to March 2020, identifying 36 suitable articles basing on inclusion criteria (primary pituitary lymphoma in adult immunocompetent subjects). Overall, 43 cases were included in the review, adding a new case diagnosed and treated in our hospital. Epidemiologic data, clinical presentation, hormonal status, radiologic findings, pathology, treatment, and outcome were extracted. RESULTS Mean age at diagnosis was 58.9 years, without gender difference. Symptoms related to mass were common (52.3%), in particular cranial nerve palsy (70.5%), headache (56.8%), and alteration in visual field (40.9%). Impaired hormonal status was detected in 89.7% of patients; of them, 58.9% presented with anterior pituitary failure (partial or total), while 25.6% presented with panhypopituitarism. Overall, diabetes insipidus was present in 30.8% and hyperprolactinemia in 41.0% of patients. The majority of patients presented a radiologically invasive mass in the suprasellar region and cavernous sinus (65.9% and 40.9%, respectively) and histologic diagnosis of diffuse B-cell lymphoma (54.5%). CONCLUSION The differential diagnosis of sellar and parasellar masses causing hypopituitarism should include primary pituitary lymphoma, even in absence of systemic symptoms or posterior pituitary dysfunction. The disease has a heterogeneous pattern, so a collaboration between endocrinologists, neuroradiologists, neurosurgeons, and hematologists is desirable.
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Affiliation(s)
- Marina Caputo
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
| | - Nunzia Prencipe
- Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Torino, Italy
| | - Alessandro Bisceglia
- Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Torino, Italy
| | - Chiara Bona
- Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Torino, Italy
| | - Mauro Maccario
- Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Torino, Italy
| | - Gianluca Aimaretti
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Silvia Grottoli
- Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Torino, Italy
| | - Valentina Gasco
- Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Torino, Italy
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Qiu T, Chanchotisatien A, Qin Z, Wu J, Chu S. Inflammatory Demyelinating Lesions: True Sentinel Lesion or Immune-Mediated Response to Lymphoma? World Neurosurg 2020; 145:172-177. [PMID: 32949800 DOI: 10.1016/j.wneu.2020.09.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Inflammatory demyelinating changes in the absence of malignant cells can sometimes be found on initial biopsies preceding the diagnosis of primary central nervous system lymphoma (PCNSL), resulting in the term "sentinel" lesion. Sentinel lesions have been reported sporadically in literature, resulting in many cases of misdiagnosis and delayed treatment. We aim to address the problem of misdiagnosis in PCNSL presenting as inflammatory demyelinating changes or sentinel lesions on initial biopsies, and to discuss our view of the mechanism underlying this phenomenon. CASE DESCRIPTION Herein we report 3 cases of PCNSL that were diagnosed via brain biopsy. We retrospectively reviewed 2 cases of initially misdiagnosed PCNSL presenting with sentinel lesions at our institution. Careful revision of preoperative magnetic resonance imaging (MRI) revealed heterogeneously enhancing tumors with strong peripheral enhancement and hypoenhancing cores. Analysis of our 2 cases revealed that initial biopsy samples in both patients were taken from the hypoenhancing regions on MRI. In the third case, we targeted the peripherally enhancing region for sampling and arrived at the proper diagnosis of PCNSL on initial biopsy. CONCLUSIONS Based on our cases and those reported in literature, we speculate that the inflammatory demyelinating changes observed on initial biopsies are immune-mediated responses that coexist with PCNSL in different tumor regions, and that they are the direct result of inadvertent sampling from hypoenhancing regions of the tumor, rather than sentinel lesions, as their name implies. We strongly recommend that biopsy target the most enhanced region on MRI when there is high clinical and radiologic suspicion for PCNSL.
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Affiliation(s)
- Tianming Qiu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneratio, Shanghai, China
| | | | - Zhiyong Qin
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneratio, Shanghai, China
| | - Jinsong Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneratio, Shanghai, China
| | - Shuguang Chu
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
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Abstract
INTRODUCTION Primary Central Nervous System Lymphoma (PCNSL) remains a diagnostic challenge due to the variable clinical manifestations. Liquid biopsies, particularly those involving cell-free DNA (cfDNA) from plasma, are rapidly emerging as important and minimally invasive adjuncts to traditional biopsies. However, conventional pathology may be still essential to obtain a diagnosis. PATIENT CONCERNS A 56-year-old woman presented with a progressive headache, dizziness, blurred vision, and lower limbs weakness with dysesthesia. Atypical clinical and radiological presentations, previous empirical treatment in another hospital, together with the patient's refusal to stereotactic brain biopsy made it challenging to diagnose. Her status deteriorated continuously during hospitalization. DIAGNOSIS Lumber punctual was performed, and CSF cytological analysis revealed malignancy cells with a high nuclear-cytoplasmic ratio. However, these cells were too loose to perform immunohistochemical stains. Genetic aberrations detections with CSF and peripheral blood sample were also inconclusive. We made a "cell-block" using the sedimentary cells collected from CSF collected through multiple aspirations via an Omaya reservoir. We further performed cytopathological and immunohistochemical analysis using this "cell-block," which finally confirmed the diagnosis of diffuse large-B cell PCNSL. INTERVENTIONS Intracranial chemotherapy began afterwards (MTX 15 mg and dexamethasone 5 mg, twice per weeks). OUTCOMES Unfortunately, this patient was dead 2 weeks later due to severe myelosuppression and secondary septic shock. CONCLUSION We provided "cell-block" method, which collects cell components from large amount of CSF for cytology and immunohistochemical analysis. "Cell-block" cytology can be an alternative diagnostic method in diagnosis of PCNSL.
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Liu CJ, Lin SY, Yang CF, Yeh CM, Kuan AS, Wang HY, Tsai CK, Gau JP, Hsiao LT, Chen PM, Liu YC, Hong YC, Ko PS, Liu JH, Lin CH. A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma. Cancer Med 2020; 9:2134-2145. [PMID: 32011103 PMCID: PMC7064125 DOI: 10.1002/cam4.2872] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/14/2019] [Accepted: 12/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background Although various prognostic models for primary central nervous system lymphoma (PCNSL) have been developed, there is no consensus regarding the optimal prognostic index. We aimed to evaluate potential prognostic factors and construct a novel predictive model for PCNSL patients. Methods We enrolled newly diagnosed PCNSL patients between 2003 and 2015. The primary endpoint was progression‐free survival (PFS), and the secondary endpoint was overall survival (OS). The prognostic factors identified using multivariate Cox proportional hazards models were used to develop a predictive model. We subsequently validated the prognostic model in an independent cohort. We also evaluated the validity of the existing scores: the International Extranodal Lymphoma Study Group (IELSG), the Nottingham/Barcelona (NB), and the Memorial Sloan‐Kettering Cancer Center models (MSKCC). Results We identified 101 patients with newly diagnosed PCNSL at our center. Multivariate analysis showed that age ≥80, deep brain lesions, and ECOG ≥2 were independent risk factors of PFS. Assigning one point for each factor, we constructed a novel prognostic model, the Taipei Score, with four distinct risk groups (0‐3 points). The performances of the Taipei Score in discriminating both PFS and OS in the training cohort were significant, and the score was validated in the external validation cohort. The IELSG, NB and MSKCC models had insufficient discriminative ability for either PFS or OS in both cohorts. Conclusion The Taipei Score is a simple model that discriminates PFS and OS for PCNSL patients. The score may offer disease risk stratification and facilitate clinical decision‐making.
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Affiliation(s)
- Chia-Jen Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Shinn-Yn Lin
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital Medical Center, Taoyuan City, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Fen Yang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chiu-Mei Yeh
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Ai-Seon Kuan
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Hao-Yuan Wang
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Kuang Tsai
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jyh-Pyng Gau
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Tsai Hsiao
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Min Chen
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yao-Chung Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Chung Hong
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Hematology and Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Po-Shen Ko
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jin-Hwang Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan.,Chong Hin Loon Memorial Cancer and Biotherapy Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Hsin Lin
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital Medical Center, Taoyuan City, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Contrast-Enhanced MRI Texture Parameters as Potential Prognostic Factors for Primary Central Nervous System Lymphoma Patients Receiving High-Dose Methotrexate-Based Chemotherapy. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:5481491. [PMID: 31777472 PMCID: PMC6875177 DOI: 10.1155/2019/5481491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 08/26/2019] [Indexed: 02/05/2023]
Abstract
Introduction The purpose of this study was to evaluate the prognostic value of texture features on contrast-enhanced magnetic resonance imaging (MRI) for patients with primary central nervous system lymphoma (PCNSL). Methods In this retrospective study, fifty-two patients diagnosed with PCNSL were enrolled from October 2010 to March 2017. The texture feature of tumor tissue on the histogram-based matrix (histo-) and the grey-level co-occurrence matrix (GLCM) was retrieved by contrast-enhanced T1-weighted imaging before any antitumor treatment. Receiver operating characteristic curve analyses were performed to obtain their optimal cutoff values, based on which we dichotomized patients into subgroups. The Kaplan–Meier analyses were conducted to compare overall survival (OS) of subgroups, and multivariate Cox regression analyses were used to determine if they could be taken as independent prognostic factors. Results Ten texture features were extracted from the MR image, including Energy, Entropy, Kurtosis, Skewness on the histogram-based matrix, and Correlation, Contrast, Dissimilarity, Energy, Entropy, and Homogeneity on the grey-level co-occurrence matrix. Three of them (GLCM-Contrast, GLCM-Dissimilarity, and GLCM-Homogeneity) are shown to be significant in relation to overall survival (OS). The multivariate Cox regression analyses suggest that GLCM-Homogeneity could be taken as independent predictors. Conclusions The texture features of contrast-enhanced magnetic resonance imaging (MRI) could potentially serve as prognostic biomarkers for PCNSL patients.
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