Outcome and prognostic factors of very old patients with primary CNS lymphoma: a retrospective analysis of patients ≥80 years treated with high-dose methotrexate-based chemotherapy

Abstract

Although >10% of primary CNS lymphoma (PCNSL) patients are ≥80 years, data on this population are limited. We analyzed 19 consecutive octogenarians with PCNSL treated with high-dose methotrexate (HD-MTX)-based chemotherapy at our institution concerning outcome, prognostic factors and living conditions at six-month follow-up for 11 patients alive and in remission. Seven patients received intracerebroventricular (ICV) treatment additional to systemic therapy. Median follow-up was 27.3 months. Median overall survival was 16.3 months. Positive prognosticators of survival were application of ICV treatment (p = 0.033) and female gender (p = 0.015). All 11 patients alive and in remission at 6-month follow-up were living at home with a median Karnofsky performance score of 60 (range 50–90) and a median instrumental activities of daily living score of 3 (range 1–8). HD-MTX-based polychemotherapy including ICV treatment was feasible in this population, patients in remission needed moderate support in everyday live.

Keywords:

• Primary CNS lymphoma
• PCNSL
• elderly patients
• high-dose methotrexate
• intracerebroventricular therapy
• octogenarians

Acknowledgements

The authors thank Friederike Bauland, Eva Brammen and Frieder Wolff from Chrestos Institut (https://chrestos.de/ci) for their statistical support and data management on this project.

Disclosure statement

R.S. received speaker’s honoraria from Roche, Gilead/Kite, Janssen, Bristol Myers Squibb; consultant’s honoraria from Gilead/Kite, Janssen, BMS Bristol Myers Squibb, Novartis. U.S. received speaker’s honoraria from Medac, GSK and Novartis. The other authors declare no conflict of interest.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This research received no external funding.