MRI Predictors of Outcome in Primary Central Nervous System Lymphoma Patients Before and After Autologous Stem Cell Transplant
Dewen Meng, Hamza Alshuft, Christopher P. Fox, Stefanie Thust, Nicolas Martinez‐CalleABSTRACT
Introduction
Primary CNS lymphoma (PCNSL) is treated with intensive chemotherapy and autologous stem cell transplant (HDT‐ASCT), yet up to one‐third of patients relapse. Standard MRI response criteria may not reliably distinguish residual tumour from post‐treatment change; additional MRI sequences, such as apparent diffusion coefficient (ADC), could assist in the determination of early relapses, although their prognostic value remains uncertain.
Methods
We retrospectively analysed 63 PCNSL patients, assessed pre‐HDT‐ASCT IPCG response and ADC values, and examined associations with 2‐year relapse‐free survival.
Results
Only pre‐HDT‐ASCT IPCG status, not the lesion ADC value, significantly predicted the 2‐year outcome ( p = 0.005). An overall CR rate of 85% was observed at a median follow‐up of 24.7 months.
Conclusions:
Pre‐HDT‐ASCT IPCG status, not ADC values, predicts 2‐year IPCG status in PCNSL patients.