Increasing use of immunotherapy and prolonged survival among younger patients with primary CNS lymphoma: a population-based study

Magdalena Neuhauser, Thomas Roetzer, Stefan Oberndorfer, Melitta Kitzwoegerer, Franz Payer, Julia J Unterluggauer, Johannes Haybaeck, Günther Stockhammer, Sarah Iglseder, Patrizia Moser, Claudius Thomé, Martin Stultschnig, Franz Wuertz, Tanisa Brandner-Kokalj, Serge Weis, Dave Bandke, Josef Pichler, Markus Hutterer, Karl J Krenosz, Alexandra BoehmBeate Mayrbaeurl, Andrea Hager-Seifert, Hannes Kaufmann, Martina Dumser, Angelika Reiner-Concin, Selma Hoenigschnabl, Waltraud Kleindienst, Markus Hoffermann, Karin Dieckmann, Barbara Kiesel, Georg Widhalm, Christine Marosi, Ulrich Jaeger, Andreas Hainfellner, Monika Hackl, Johannes A Hainfellner, Matthias Preusser, Adelheid Woehrer

Research output: Journal article (peer-reviewed)Journal article

4 Citations (Scopus)

Abstract

Background: Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups. Material and Methods: Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates. Results: We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis. Conclusion: In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.

Original languageEnglish
Pages (from-to)967-976
Number of pages10
JournalActa Oncologica
Volume58
Issue number7
DOIs
Publication statusPublished - 3 Jul 2019

Keywords

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents, Immunological/therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Austria/epidemiology
  • Brain Neoplasms/drug therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma, Non-Hodgkin/drug therapy
  • Male
  • Methotrexate/therapeutic use
  • Middle Aged
  • Prognosis
  • Progression-Free Survival
  • Registries/statistics & numerical data
  • Rituximab/therapeutic use
  • Survival Analysis
  • Young Adult

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