Primary Central Nervous System Lymphomas: A Single-center Experience

Objectives: Primary central nervous system lymphoma (PCNSL) is a rare and aggressive form of non-Hodgkin lymphoma (NHL). This study aimed to investigate the characteristics, treatment approaches, and outcomes of patients with PCNSL in a single institution. Methods: We retrospectively analyzed 11 patients with PCNSL treated at our institution between October 2022 and July 2024. Patient demographics, clinical characteristics, treatment modalities, and outcomes were evaluated. Results: The median age of the patients was 65 years, with male predominance (63.64%). The median follow-up duration was 10 months. All patients were immunocompetent, and 90.91% had diffuse large B-cell lymphoma. At diagnosis, 81% of the patients were considered fit to receive HDMTX treatment. R-MPV was the most common first-line treatment (45.45%). The complete response rate to initial treatment was 80%. The treatment-related mortality was 9.09%. Autologous stem cell transplantation (ASCT) was performed in 72.73% of the patients, with rituximab-thiotepa-carmustine as the predominant conditioning regimen (62.50%). Treatment-related toxicities occurred in 50% of patients, and 87.50% of patients experienced transplant-related complications. The transplantation-related mortality rate was 25%. The relapse rate was 25% among the patients undergoing ASCT. The mortality rate was 36.36%, and cerebellar involvement was significantly associated with a higher mortality rate (p=0.045). Conclusion: This study demonstrated the efficacy of methotrexate-based regimens and ASCT in the treatment of PCNSL and achieved high complete response rates. However, the significant incidence of treatment-related toxicities and mortality underscores the persistent challenges of managing this disease. In addition, the association between cerebellar involvement and increased mortality requires further investigation. Larger prospective studies are needed to validate these findings.