Geo et al evaluate prognostic factors in patients with primary CNS lymphoma. These can help to identify patients who require more aggressive management. The authors are from multiple institutions in China, Italy and Austria.
Patient selection - all of the following:
(1) disease localized exclusively in the brain, leptomeninges, spinal cord or eyes without systemic involvement
(2) seronegative for HIV
(3) no history of immunosuppression or organ transplant
(4) no other malignancy
(5) no previous anticancer treatment
(6) adequate follow-up data
Parameters from multivariate analysis:
(1) Memorial Sloan Kettering Cancer Center (MSKCC) prognostic model
(2) LDH to Lymphocyte ratio (LLR)
LDH to lymphocyte ratio =
= (serum LDH in U/L) / (absolute lymphocyte count in 10^9/L)
|
Parameter
|
Finding
|
HR for Worse Survival
|
|
MSKCC
|
low
|
1
|
|
|
intermediate
|
1.2
|
|
|
high
|
2.9
|
|
LLR
|
<= 168.8
|
1
|
|
|
> 168.8
|
1.8
|
Additional risk factors from univariate analysis:
(1) age > 60 years
(2) ECOG performance status > 1
(3) neutrophil to lymphocyte ratio > 4.74
