EUH Hunt Conference: What is the prognosis for patients with HIV-negative PCNSL?

The Bottom Line: Patients diagnosed with primary central nervous system lymphoma (PCNSL) who are HIV-negative have a higher prognosis compared to those with PCNSL who are HIV-positive. While the median survival range is from 10-20 months for HIV-positive PCNSL patients, there is more variability for HIV-negative patients, survival ranging from 12 to 37 months or longer.

References: Bayraktar, S., Bayraktar, U.D., Ramos, J.C. et al. Primary CNS lymphoma in HIV positive and negative patients: Comparison of clinical characteristics, outcome, and prognostic factors. J Neurooncol. 2011;101(2): 257-265.

DynaMed Plus [Internet]. Ipswich (MA): EBSCO Information Services. 1995 – . Record No. 115176, Primary central nervous system lymphoma; [updated 2017 Nov 29, cited 2018 April 25]; [about 14 screens].

Fadul CE & Ely P. Schmidek and Sweet’s Operative Nurosurgical Techniques. [Internet]. Philadelphia: Saunders; 2012 Jun. Chapter 12: Management of primary central nervous system lymphomas;[cited 2018 April 25]; p.149-159.

Gerstner ER, Batchelor TT. Primary Central Nervous System LymphomaArch Neurol. 2010;67(3):291–297. doi:10.1001/archneurol.2010.3

Norden, A.D., Drappatz, J., Wen, P.Y. et al. Survival among patients with primary central nervous system lymphoma, 1973-2004. J Neurooncol. 2011;101(3): 487-493.

Westin JR, Konoplev SN, Fayad LE, Medeiros L. Aggressive B-Cell Lymphomas. In: Kantarjian HM, Wolff RA. eds. The MD Anderson Manual of Medical Oncology, 3eNew York, NY: McGraw-Hill. Accessed April 25, 2018.

Summary: Factors such as age and type of treatment patients receive impact their overall survival rate. However, the most important prognostic factor is the status of the patient’s health prior to receiving treatment. Many patients can improve their condition by use of corticosteroids and thus be candidates for intensive chemotherapy-based regimens that are potentially curative (Westin, Konoplev, Fayad, and Medeiros, 2018).