Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma

Abstract This study examined the prevalence, risk factors, and prognosis of epilepsy in patients with primary central nervous system lymphoma (PCNSL) and explored the necessity of prophylactic antiepileptic treatment in this population. In this retrospective, observational, single-center study, we a...

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Main Authors: Mengxue Zhang, Yunan Ling, Yanwei Zeng, Jingjing Ma, Zhiguang Lin, Qing Li, Hui Kang, Bobin Chen, Yan Ma
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-94477-1
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author Mengxue Zhang
Yunan Ling
Yanwei Zeng
Jingjing Ma
Zhiguang Lin
Qing Li
Hui Kang
Bobin Chen
Yan Ma
author_facet Mengxue Zhang
Yunan Ling
Yanwei Zeng
Jingjing Ma
Zhiguang Lin
Qing Li
Hui Kang
Bobin Chen
Yan Ma
author_sort Mengxue Zhang
collection DOAJ
description Abstract This study examined the prevalence, risk factors, and prognosis of epilepsy in patients with primary central nervous system lymphoma (PCNSL) and explored the necessity of prophylactic antiepileptic treatment in this population. In this retrospective, observational, single-center study, we analyzed clinical data from PCNSL patients who were diagnosed at our institution between January 2018 and April 2023. The cohort comprised 214 patients with PCNSL (with a median age of 62 years), of which 128 (47.6%) patients were male. Epilepsy was observed in 16.82% (36/214) of the patients, with 9.35% (20/214) presenting with seizures as the initial symptom. Cortical involvement was significantly associated with seizures (OR = 9.512, 95% CI 3.870–23.381; p = 0.036). Other potential risk factors included an edema zone > 1 cm around the lesion and PIM1 wild-type status. Antiepileptic drugs (AEDs) neither reduced seizure incidence (8.11% with AEDs vs. 8.43% with no AEDs, p = 0.970) nor improved PFS (HR = 0.613, 95% CI 0.338–1.109; p = 0.106). Therefore, AEDs should not be used as preventive measures in this population.
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spelling doaj-art-d21507a950bb4b2ab6ec6fccf1512ffd2025-08-20T02:51:28ZengNature PortfolioScientific Reports2045-23222025-03-0115111410.1038/s41598-025-94477-1Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphomaMengxue Zhang0Yunan Ling1Yanwei Zeng2Jingjing Ma3Zhiguang Lin4Qing Li5Hui Kang6Bobin Chen7Yan Ma8Department of Hematology, Huashan Hospital, Fudan UniversityDepartment of Hematology, Huashan Hospital, Fudan UniversityDepartment of Radiology, Huashan Hospital, Fudan UniversityDepartment of Hematology, Huashan Hospital, Fudan UniversityDepartment of Hematology, Huashan Hospital, Fudan UniversityDepartment of Hematology, Huashan Hospital, Fudan UniversityDepartment of Physical Examination, Huashan Hospital, Fudan UniversityDepartment of Hematology, Huashan Hospital, Fudan UniversityDepartment of Hematology, Huashan Hospital, Fudan UniversityAbstract This study examined the prevalence, risk factors, and prognosis of epilepsy in patients with primary central nervous system lymphoma (PCNSL) and explored the necessity of prophylactic antiepileptic treatment in this population. In this retrospective, observational, single-center study, we analyzed clinical data from PCNSL patients who were diagnosed at our institution between January 2018 and April 2023. The cohort comprised 214 patients with PCNSL (with a median age of 62 years), of which 128 (47.6%) patients were male. Epilepsy was observed in 16.82% (36/214) of the patients, with 9.35% (20/214) presenting with seizures as the initial symptom. Cortical involvement was significantly associated with seizures (OR = 9.512, 95% CI 3.870–23.381; p = 0.036). Other potential risk factors included an edema zone > 1 cm around the lesion and PIM1 wild-type status. Antiepileptic drugs (AEDs) neither reduced seizure incidence (8.11% with AEDs vs. 8.43% with no AEDs, p = 0.970) nor improved PFS (HR = 0.613, 95% CI 0.338–1.109; p = 0.106). Therefore, AEDs should not be used as preventive measures in this population.https://doi.org/10.1038/s41598-025-94477-1Primary central nervous system lymphoma (PCNSL)EpilepsyPrevalenceRisk factorsPrognosis
spellingShingle Mengxue Zhang
Yunan Ling
Yanwei Zeng
Jingjing Ma
Zhiguang Lin
Qing Li
Hui Kang
Bobin Chen
Yan Ma
Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma
Scientific Reports
Primary central nervous system lymphoma (PCNSL)
Epilepsy
Prevalence
Risk factors
Prognosis
title Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma
title_full Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma
title_fullStr Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma
title_full_unstemmed Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma
title_short Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma
title_sort antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary cns lymphoma
topic Primary central nervous system lymphoma (PCNSL)
Epilepsy
Prevalence
Risk factors
Prognosis
url https://doi.org/10.1038/s41598-025-94477-1
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