# Outcomes for Primary Central Nervous System Lymphoma from a Single Institution

## TL;DR

This study examines outcomes for primary central nervous system lymphoma patients treated at a single institution, highlighting the impact of treatment cycles and the need for improved therapies.

## Contribution

The study provides insights into treatment efficacy and outcomes in an elderly and sub-rural PCNSL patient cohort.

## Key findings

- Completion of ≥six cycles of induction therapy was predictive of response in PCNSL patients.
- Combination chemoimmunotherapy showed efficacy regardless of age in this cohort.
- Non-relapse mortality remains a critical consideration in PCNSL treatment.

## Abstract

Background: Primary central nervous lymphoma (PCNSL) is a rare, aggressive, non-Hodgkin’s lymphoma. Outcomes are poor with standard induction of high-dose methotrexate (HD-MTX)-based regimens and consolidation. We present retrospective data from the Georgia Cancer Center. Methods: A single retrospective chart review was conducted on all PCNSL patients from 2013 to 2023 to assess for various factors influencing care. Results: Of a total of 38 PCNSL patients, 6 died and 2 were lost to follow-up prior to therapy initiation, leading to a total of 30 patients for analysis. The median age was 62.3 (21–82 years). One patient had HIV/AIDS. Two patients were on immunosuppression for either kidney transplant or multiple sclerosis (MS). The HIV and MS cases were Epstein-Barr Virus (EBV)-positive. Completion of ≥six cycles of induction was predictive of response. Conclusions: PCNSL remains an area of high unmet need. Recent studies have shown that HD-MTX-based therapy and autologous stem cell transplantation afterwards leads to improved outcomes regardless of age; however, non-relapse mortality is important to consider. Our data from a primarily elderly and sub-rural cohort reiterate the efficacy of combination chemoimmunotherapy and impact of induction cycle number on response, regardless of age. A multidisciplinary approach and targeted agent maintenance should be considered to improve outcomes in the elderly.