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A new prognostic model using absolute lymphocyte count in patients with primary central nervous system lymphoma

 Ji Eun Jang  ;  Yu Ri Kim  ;  Soo-Jeong Kim  ;  Hyunsoo Cho  ;  Haerim Chung  ;  Jung Yeon Lee  ;  Hyunsung Park  ;  Yundeok Kim  ;  June-Won Cheong  ;  Yoo Hong Min  ;  Jin Seok Kim 
 EUROPEAN JOURNAL OF CANCER, Vol.57 : 127-135, 2016 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Busulfan/administration & dosage ; Central Nervous System Neoplasms/diagnosis ; Central Nervous System Neoplasms/mortality* ; Central Nervous System Neoplasms/therapy ; Combined Modality Therapy ; Dexamethasone/administration & dosage ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphocyte Count/methods ; Lymphoma, Non-Hodgkin/diagnosis ; Lymphoma, Non-Hodgkin/mortality* ; Lymphoma, Non-Hodgkin/therapy ; Lymphopenia/etiology ; Lymphopenia/mortality* ; Male ; Methotrexate/administration & dosage ; Middle Aged ; Prognosis ; Stem Cell Transplantation ; Thiotepa/administration & dosage ; Transplantation, Autologous ; Vincristine/administration & dosage
Lymphopenia ; Primary central nervous system lymphoma ; Prognosis
PURPOSE: Primary central nervous system lymphoma (PCNSL) is an aggressive and rare extranodal non-Hodgkin lymphoma (NHL). Absolute lymphocyte count (ALC) has been suggested to have a prognostic value in several subtypes of NHL. We evaluated the prognostic significance of clinical factors, including ALC, in patients with PCNSL to develop a new prognostic model.
METHODS: We analysed prognostic factors, including ALC, at diagnosis in 81 PCNSL patients receiving high-dose methotrexate-based therapy.
RESULTS: The median ALC at diagnosis was 1210 × 10(6)/L (range, 210-3610), with lymphopenia (≤ 875 × 10(6)/L) being detected in 27 (33.3%) patients. In the multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG PS) >1 (hazard ratio [HR] 3.18, P=0.003), age >50 years (HR 4.23, P=0.012), and lymphopenia at diagnosis (HR 2.83, P=0.008) remained independent prognostic factors for low overall survival (OS). Lymphopenia was also a significant prognostic factor for progression-free survival (HR 3.17, P=0.001). By means of a new three-factor prognostic model using ECOG PS >1, age >50 years, and presence of lymphopenia, with 1 point assigned to each factor, we successfully classified the patients into three risk groups: low (0 and 1), intermediate (2), and high (3). The 5-year OS rates of the patients in the low-, intermediate-, and high-risk groups were 74.3%, 21.7%, and 12.5%, respectively (P<0.001).
CONCLUSIONS: Low ALC is a useful indicator of poor prognosis in patients with PCNSL. The proposed three-factor model should be validated in large-scale studies.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Yun Deok(김윤덕) ORCID logo https://orcid.org/0000-0002-5336-7936
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Park, Hyeun Sung(박현성)
Lee, Jung Yoen(이정연)
Jang, Ji Eun(장지은) ORCID logo https://orcid.org/0000-0001-8832-1412
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Chung, Hae Rim(정해림) ORCID logo https://orcid.org/0000-0002-7926-9285
Cho, Hyunsoo(조현수) ORCID logo https://orcid.org/0000-0003-2651-6403
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