Primary CNS lymphoma in children and adolescents: A descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG)

Oussama Abla, Sheila Weitzman, Jean Yves Blay, Brian Patrick O'Neill, Lauren E. Abrey, Edward Neuwelt, Nancy D. Doolittle, Joachim Baehring, Kamnesh Pradhan, S. Eric Martin, Michael Guerrera, Shafqat Shah, Hervé Ghesquieres, Michael Silver, Rebecca Betensky, Tracy Batchelor

Research output: Contribution to journalArticle

Abstract

Purpose: To describe the demographic and clinical features and outcomes for children and adolescents with primary CNS lymphoma (PCNSL). Experimental Design: A retrospective series of children and adolescents with PCNSL was assembled from 10 cancer centers in 3 countries. Results: Twenty-nine patients with a median age of 14 years were identified. Sixteen (55%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or greater. Frontline therapy consisted of chemotherapy only in 20 patients (69%), while 9 (31%) had chemotherapy plus cranial radiotherapy. Most patients received methotrexate (MTX)-based regimens. Overall response rate was 86% (complete remission 69%, partial remission 17%). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 61% and 86%, respectively; the 3-year OS was 82%. Univariate analyses were conducted for age (≤14 vs. >14 years), PS (0 or 1 vs. >1), deep brain lesions, MTX dose, primary treatment with chemotherapy alone, intrathecal chemotherapy, and high-dose therapy. Primary treatment with chemotherapy alone was associated with better overall response rates with an odds ratio (OR) of 0.125 (P = 0.02). There was a marginally significant relationship between higher doses of MTX and response (OR = 1.5, P = 0.06). ECOG-PS of 0 to 1 was the only factor associated with better outcome with hazard ratios of 0.136 (P = 0.017) and 0.073 (P = 0.033) for PFS and OS, respectively. Conclusion: This is the largest series collected of pediatric PCNSL. The outcome of children and adolescents seems to be better than in adults. PS of 0 to 1 is associated with better survival.

Original languageEnglish (US)
Pages (from-to)346-352
Number of pages7
JournalClinical Cancer Research
Volume17
Issue number2
DOIs
StatePublished - Jan 15 2011

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Lymphoma
Drug Therapy
Methotrexate
Disease-Free Survival
Survival
Odds Ratio
Therapeutics
Research Design
Radiotherapy
Survival Rate
Demography
Pediatrics
Brain
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Primary CNS lymphoma in children and adolescents : A descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG). / Abla, Oussama; Weitzman, Sheila; Blay, Jean Yves; O'Neill, Brian Patrick; Abrey, Lauren E.; Neuwelt, Edward; Doolittle, Nancy D.; Baehring, Joachim; Pradhan, Kamnesh; Martin, S. Eric; Guerrera, Michael; Shah, Shafqat; Ghesquieres, Hervé; Silver, Michael; Betensky, Rebecca; Batchelor, Tracy.

In: Clinical Cancer Research, Vol. 17, No. 2, 15.01.2011, p. 346-352.

Research output: Contribution to journalArticle

Abla, O, Weitzman, S, Blay, JY, O'Neill, BP, Abrey, LE, Neuwelt, E, Doolittle, ND, Baehring, J, Pradhan, K, Martin, SE, Guerrera, M, Shah, S, Ghesquieres, H, Silver, M, Betensky, R & Batchelor, T 2011, 'Primary CNS lymphoma in children and adolescents: A descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG)', Clinical Cancer Research, vol. 17, no. 2, pp. 346-352. https://doi.org/10.1158/1078-0432.CCR-10-1161
Abla, Oussama ; Weitzman, Sheila ; Blay, Jean Yves ; O'Neill, Brian Patrick ; Abrey, Lauren E. ; Neuwelt, Edward ; Doolittle, Nancy D. ; Baehring, Joachim ; Pradhan, Kamnesh ; Martin, S. Eric ; Guerrera, Michael ; Shah, Shafqat ; Ghesquieres, Hervé ; Silver, Michael ; Betensky, Rebecca ; Batchelor, Tracy. / Primary CNS lymphoma in children and adolescents : A descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG). In: Clinical Cancer Research. 2011 ; Vol. 17, No. 2. pp. 346-352.
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abstract = "Purpose: To describe the demographic and clinical features and outcomes for children and adolescents with primary CNS lymphoma (PCNSL). Experimental Design: A retrospective series of children and adolescents with PCNSL was assembled from 10 cancer centers in 3 countries. Results: Twenty-nine patients with a median age of 14 years were identified. Sixteen (55{\%}) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or greater. Frontline therapy consisted of chemotherapy only in 20 patients (69{\%}), while 9 (31{\%}) had chemotherapy plus cranial radiotherapy. Most patients received methotrexate (MTX)-based regimens. Overall response rate was 86{\%} (complete remission 69{\%}, partial remission 17{\%}). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 61{\%} and 86{\%}, respectively; the 3-year OS was 82{\%}. Univariate analyses were conducted for age (≤14 vs. >14 years), PS (0 or 1 vs. >1), deep brain lesions, MTX dose, primary treatment with chemotherapy alone, intrathecal chemotherapy, and high-dose therapy. Primary treatment with chemotherapy alone was associated with better overall response rates with an odds ratio (OR) of 0.125 (P = 0.02). There was a marginally significant relationship between higher doses of MTX and response (OR = 1.5, P = 0.06). ECOG-PS of 0 to 1 was the only factor associated with better outcome with hazard ratios of 0.136 (P = 0.017) and 0.073 (P = 0.033) for PFS and OS, respectively. Conclusion: This is the largest series collected of pediatric PCNSL. The outcome of children and adolescents seems to be better than in adults. PS of 0 to 1 is associated with better survival.",
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T1 - Primary CNS lymphoma in children and adolescents

T2 - A descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG)

AU - Abla, Oussama

AU - Weitzman, Sheila

AU - Blay, Jean Yves

AU - O'Neill, Brian Patrick

AU - Abrey, Lauren E.

AU - Neuwelt, Edward

AU - Doolittle, Nancy D.

AU - Baehring, Joachim

AU - Pradhan, Kamnesh

AU - Martin, S. Eric

AU - Guerrera, Michael

AU - Shah, Shafqat

AU - Ghesquieres, Hervé

AU - Silver, Michael

AU - Betensky, Rebecca

AU - Batchelor, Tracy

PY - 2011/1/15

Y1 - 2011/1/15

N2 - Purpose: To describe the demographic and clinical features and outcomes for children and adolescents with primary CNS lymphoma (PCNSL). Experimental Design: A retrospective series of children and adolescents with PCNSL was assembled from 10 cancer centers in 3 countries. Results: Twenty-nine patients with a median age of 14 years were identified. Sixteen (55%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or greater. Frontline therapy consisted of chemotherapy only in 20 patients (69%), while 9 (31%) had chemotherapy plus cranial radiotherapy. Most patients received methotrexate (MTX)-based regimens. Overall response rate was 86% (complete remission 69%, partial remission 17%). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 61% and 86%, respectively; the 3-year OS was 82%. Univariate analyses were conducted for age (≤14 vs. >14 years), PS (0 or 1 vs. >1), deep brain lesions, MTX dose, primary treatment with chemotherapy alone, intrathecal chemotherapy, and high-dose therapy. Primary treatment with chemotherapy alone was associated with better overall response rates with an odds ratio (OR) of 0.125 (P = 0.02). There was a marginally significant relationship between higher doses of MTX and response (OR = 1.5, P = 0.06). ECOG-PS of 0 to 1 was the only factor associated with better outcome with hazard ratios of 0.136 (P = 0.017) and 0.073 (P = 0.033) for PFS and OS, respectively. Conclusion: This is the largest series collected of pediatric PCNSL. The outcome of children and adolescents seems to be better than in adults. PS of 0 to 1 is associated with better survival.

AB - Purpose: To describe the demographic and clinical features and outcomes for children and adolescents with primary CNS lymphoma (PCNSL). Experimental Design: A retrospective series of children and adolescents with PCNSL was assembled from 10 cancer centers in 3 countries. Results: Twenty-nine patients with a median age of 14 years were identified. Sixteen (55%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or greater. Frontline therapy consisted of chemotherapy only in 20 patients (69%), while 9 (31%) had chemotherapy plus cranial radiotherapy. Most patients received methotrexate (MTX)-based regimens. Overall response rate was 86% (complete remission 69%, partial remission 17%). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 61% and 86%, respectively; the 3-year OS was 82%. Univariate analyses were conducted for age (≤14 vs. >14 years), PS (0 or 1 vs. >1), deep brain lesions, MTX dose, primary treatment with chemotherapy alone, intrathecal chemotherapy, and high-dose therapy. Primary treatment with chemotherapy alone was associated with better overall response rates with an odds ratio (OR) of 0.125 (P = 0.02). There was a marginally significant relationship between higher doses of MTX and response (OR = 1.5, P = 0.06). ECOG-PS of 0 to 1 was the only factor associated with better outcome with hazard ratios of 0.136 (P = 0.017) and 0.073 (P = 0.033) for PFS and OS, respectively. Conclusion: This is the largest series collected of pediatric PCNSL. The outcome of children and adolescents seems to be better than in adults. PS of 0 to 1 is associated with better survival.

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