Prognostic factors in primary central nervous system lymphoma

被引:7
作者
Morales-Martinez, Andrea [1 ]
Nichelli, Lucia [2 ]
Hernandez-Verdin, Isaias [3 ]
Houillier, Caroline [1 ]
Alentorn, Agusti [1 ,3 ]
Khe Hoang-Xuan [1 ,3 ]
机构
[1] Sorbonne Univ, AP HP, IHU, Serv Neurol Mazarin 2, Paris, France
[2] Sorbonne Univ, Grp Hosp Salpetriere, AP HP, ICM,Serv Neuroradiol, Paris, France
[3] ICM Inst Cerveau, Lab Genet & Dev Tumeurs Cerebrates, INSERM, CNRS,UMR S 1127, Paris, France
关键词
immunocompetent; primary central nervous system lymphoma; prognosis; risk factors; PRIMARY CNS LYMPHOMA; INTERNATIONAL EXTRANODAL LYMPHOMA; APPARENT DIFFUSION-COEFFICIENT; HIGH-DOSE METHOTREXATE; WHOLE-BRAIN RADIOTHERAPY; B-CELL LYMPHOMA; IMMUNOCOMPETENT PATIENTS; CEREBROSPINAL-FLUID; ELDERLY-PATIENTS; POOR-PROGNOSIS;
D O I
10.1097/CCO.0000000000000896
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of review Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal diffuse large B cell lymphoma. Despite its apparent immunopathological homogeneity, PCNSL displays a wide variability in outcome. Identifying prognostic factors is of importance for patient stratification and clinical decision-making. The purpose of this review is to focus on the clinical, neuroradiological and biological variables correlated with the prognosis at the time of diagnosis in immunocompetent patients. Recent findings Age and performance status remain the most consistent clinical prognostic factors. The current literature suggests that neurocognitive dysfunction is an independent predictor of poor outcome. Cumulating data support the prognostic value of increased interleukin-10 level in the cerebrospinal fluid (CSF), in addition to its interest as a diagnostic biomarker. Advances in neuroimaging and in omics have identified several semi-quantitative radiological features (apparent diffusion restriction measures, dynamic contrast-enhanced perfusion MRI (pMRI) pattern and F-18-fluorodeoxyglucose metabolism) and molecular genetic alterations with prognostic impact in PCNSL. Summary Validation of new biologic and neuroimaging markers in prospective studies is required before integrating future prognostic scoring systems. In the era of radiomic, large clinicoradiological and molecular databases are needed to develop multimodal artificial intelligence algorithms for the prediction of accurate outcome.
引用
收藏
页码:676 / 684
页数:9
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