PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma
Abstract High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation has significantly improved overall survival (OS) in primary central nervous system lymphoma (PCNSL). However, early identification of long-term survivors remains a challenge. Progression-free survival at 2...
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BMC
2025-04-01
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| Series: | Journal of Hematology & Oncology |
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| Online Access: | https://doi.org/10.1186/s13045-025-01700-7 |
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| author | Vanja Zeremski Tobias R. Haage Hanno M. Witte Louisa Adolph Sina A. Beer Gerhard Behre Benedikt Jacobs Christoph Kahl Chrysavgi Lalayanni Jens Panse Sotirios Papageorgiou Marina P. Siakantaris Jessica Schneider Ulf Schnetzke Alexander Schulz Theodoros P. Vassilakopoulos Jeanette Walter Dimitrios Mougiakakos |
| author_facet | Vanja Zeremski Tobias R. Haage Hanno M. Witte Louisa Adolph Sina A. Beer Gerhard Behre Benedikt Jacobs Christoph Kahl Chrysavgi Lalayanni Jens Panse Sotirios Papageorgiou Marina P. Siakantaris Jessica Schneider Ulf Schnetzke Alexander Schulz Theodoros P. Vassilakopoulos Jeanette Walter Dimitrios Mougiakakos |
| author_sort | Vanja Zeremski |
| collection | DOAJ |
| description | Abstract High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation has significantly improved overall survival (OS) in primary central nervous system lymphoma (PCNSL). However, early identification of long-term survivors remains a challenge. Progression-free survival at 24 months (PFS24) has emerged as a key prognostic marker in diffuse large B-cell lymphoma, but its relevance in PCNSL is still unclear. In this retrospective multicenter study, we analyzed data from 146 newly diagnosed, transplant-eligible PCNSL patients treated with MATRix-like regimens across 14 hospitals. With a median follow-up of 48 months, the 2-year PFS and OS rates were 50.4% and 65.6%, respectively. Of the 139 patients evaluable for PFS24-analysis, 51.1% reached PFS24, with a subsequent 5-year OS of 96.7%. Of note, the annual hazard rate for progression and death decreased to under 5% after 24 months, remaining stable thereafter. The patients who failed to reach PFS24 had a median OS of only 6.0 months. Key predictors of PFS failure included impaired Karnofsky performance status and treatment dose-reduction. In conclusion, PFS24 was identified as an important prognostic marker in PCNSL. Patients who achieve PFS24 have a favorable prognosis, whereas those who do not face poor outcomes and require innovative treatment approaches. This insight could aid in risk stratification and support the use of PFS24 as a surrogate endpoint in clinical trials. |
| format | Article |
| id | doaj-art-ced42f967dbc46b18af83253b32f12ae |
| institution | OA Journals |
| issn | 1756-8722 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj-art-ced42f967dbc46b18af83253b32f12ae2025-08-20T02:19:58ZengBMCJournal of Hematology & Oncology1756-87222025-04-011811410.1186/s13045-025-01700-7PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphomaVanja Zeremski0Tobias R. Haage1Hanno M. Witte2Louisa Adolph3Sina A. Beer4Gerhard Behre5Benedikt Jacobs6Christoph Kahl7Chrysavgi Lalayanni8Jens Panse9Sotirios Papageorgiou10Marina P. Siakantaris11Jessica Schneider12Ulf Schnetzke13Alexander Schulz14Theodoros P. Vassilakopoulos15Jeanette Walter16Dimitrios Mougiakakos17Department of Hematology, Oncology and Cell Therapy, Medical Faculty, Otto von Guericke University MagdeburgDepartment of Hematology, Oncology and Cell Therapy, Medical Faculty, Otto von Guericke University MagdeburgDepartment of Hematology and Oncology, Federal Armed Forces Hospital UlmDepartment of Internal Medicine III, Ludwig-Maximilians-University HospitalDepartment of Hematology and Oncology, University Hospital TuebingenDessau Medical Center, Clinic for Internal Medicine I– Gastroenterology, Hematology, Oncology, Hemostaseology, Palliative Medicine, Infectious Diseases, PneumologyDepartment of Internal Medicine 5, Hematology and Clinical Oncology, Friedrich-Alexander- Universität Erlangen-Nürnberg (FAU), University Hospital ErlangenDepartment of Hematology, Oncology and Palliative Care, Klinikum MagdeburgBone Marrow Transplantation Unit, Hematology Department, G. Papanicolaou HospitalDepartment of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen UniversitySecond Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University General HospitalDepartment of Hematology and Bone Marrow Transplantation Unit, National and Kapodistrian University of Athens, Laiko General HospitalDepartment of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical SchoolDepartment of Internal Medicine II, Hematology and Medical Oncology, University Hospital JenaDessau Medical Center, Clinic for Internal Medicine I– Gastroenterology, Hematology, Oncology, Hemostaseology, Palliative Medicine, Infectious Diseases, PneumologyDepartment of Hematology and Bone Marrow Transplantation Unit, National and Kapodistrian University of Athens, Laiko General HospitalDepartment of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen UniversityDepartment of Hematology, Oncology and Cell Therapy, Medical Faculty, Otto von Guericke University MagdeburgAbstract High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation has significantly improved overall survival (OS) in primary central nervous system lymphoma (PCNSL). However, early identification of long-term survivors remains a challenge. Progression-free survival at 24 months (PFS24) has emerged as a key prognostic marker in diffuse large B-cell lymphoma, but its relevance in PCNSL is still unclear. In this retrospective multicenter study, we analyzed data from 146 newly diagnosed, transplant-eligible PCNSL patients treated with MATRix-like regimens across 14 hospitals. With a median follow-up of 48 months, the 2-year PFS and OS rates were 50.4% and 65.6%, respectively. Of the 139 patients evaluable for PFS24-analysis, 51.1% reached PFS24, with a subsequent 5-year OS of 96.7%. Of note, the annual hazard rate for progression and death decreased to under 5% after 24 months, remaining stable thereafter. The patients who failed to reach PFS24 had a median OS of only 6.0 months. Key predictors of PFS failure included impaired Karnofsky performance status and treatment dose-reduction. In conclusion, PFS24 was identified as an important prognostic marker in PCNSL. Patients who achieve PFS24 have a favorable prognosis, whereas those who do not face poor outcomes and require innovative treatment approaches. This insight could aid in risk stratification and support the use of PFS24 as a surrogate endpoint in clinical trials.https://doi.org/10.1186/s13045-025-01700-7Primary CNS lymphomaPFS24Overall survival |
| spellingShingle | Vanja Zeremski Tobias R. Haage Hanno M. Witte Louisa Adolph Sina A. Beer Gerhard Behre Benedikt Jacobs Christoph Kahl Chrysavgi Lalayanni Jens Panse Sotirios Papageorgiou Marina P. Siakantaris Jessica Schneider Ulf Schnetzke Alexander Schulz Theodoros P. Vassilakopoulos Jeanette Walter Dimitrios Mougiakakos PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma Journal of Hematology & Oncology Primary CNS lymphoma PFS24 Overall survival |
| title | PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma |
| title_full | PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma |
| title_fullStr | PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma |
| title_full_unstemmed | PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma |
| title_short | PFS24 as a prognostic milestone in patients with newly diagnosed primary CNS lymphoma |
| title_sort | pfs24 as a prognostic milestone in patients with newly diagnosed primary cns lymphoma |
| topic | Primary CNS lymphoma PFS24 Overall survival |
| url | https://doi.org/10.1186/s13045-025-01700-7 |
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