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Central nervous system lymphoma in immunocompetent patients: The North Shore-Long Island Jewish Health System experience
Authors:Xinmin Zhang  Qiang Hua Chen  Peter Farmer  Mansoor Nasim  Alexis Demopoulos  Craig Devoe  Tulika Ranjan  Mark B. Eisenberg  Michael Schulder  Chengpeng Bi  Jian Yi Li
Affiliation:1. Department of Pathology and Laboratory Medicine, North Shore–Long Island Jewish Health System, Hofstra North Shore-LIJ School of Medicine, 6 Ohio Drive, Suite 202, Lake Success, NY 11042, USA;2. Tisch Cancer Institute, Mount Sinai School of Medicine, NY, USA;3. Division of Hematology/Oncology, North Shore University Hospital, Manhasset, NY, USA;4. Division of Neurology, Duke University, Durham, NC, USA;5. Department of Neurosurgery, North Shore University Hospital, Manhasset, NY, USA;6. Bioinformatics and Intelligent Computing Laboratory, Division of Clinical Pharmacology, Children’s Mercy Hospitals, Schools of Medicine, Computing and Engineering, University of Missouri, Kansas City, MO, USA
Abstract:Of the 74 immunocompetent patients diagnosed between July 2004 and June 2011 at the North Shore University Hospital and Long Island Jewish Medical Center with primary central nervous system lymphoma, 71 (95.9%) had diffuse large B-cell lymphomas (DLBCL). The median patient age was 68 years (range: 19–87 years) with a slight male preponderance (1.1:1). The overall median survival time was 21 months. For patients older than 70 years, the median survival time was 8 months while for those 70 years or younger, the median survival time was 27 months (p < 0.01). Female patients had a worse prognosis than male patients (p < 0.05, median survival time, 17 months compared to 23 months). We had enough data from 52 of these 71 patients to define the lymphomas as either germinal center B-cell-like (GCB) or activated B-cell-like (ABC) DLBCL. Of these 52 patients, 42 (80.8%) had ABC DLBCL while only 10 (19.2%) had GCB DLBCL. The patients in the GCB subgroup seemed to survive longer than the patients in the ABC subgroup, although the difference did not reach statistical significance. No statistically significant difference in overall survival was seen between patients with BCL-6 positive or negative DLBCL; or between patients with BCL-2 positive or negative DLBCL.
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