Prognostic factors in primary central nervous system lymphoma

Area of Science:

• Oncology
• Neurology
• Immunology

Background:

• Primary central nervous system lymphoma (PCNSL) is a rare, aggressive non-Hodgkin lymphoma.
• Despite seeming uniformity, PCNSL shows significant outcome variability.
• Accurate prognostic factors are crucial for patient stratification and clinical management.

Purpose of the Study:

• To review clinical, neuroradiological, and biological prognostic factors for PCNSL.
• Focus on factors identified at the time of diagnosis in immunocompetent patients.

Main Methods:

• Literature review of clinical, imaging, and molecular data.
• Analysis of prognostic variables in PCNSL.

Main Results:

• Consistent clinical factors: age and performance status.
• Neurocognitive dysfunction is an independent poor prognostic indicator.
• Elevated CSF interleukin-10, specific MRI features (e.g., diffusion restriction, perfusion patterns), and molecular alterations show prognostic value.

Conclusions:

• Further validation of novel biomarkers in prospective studies is needed.
• Development of multimodal AI algorithms using large datasets is essential for accurate outcome prediction in the radiomic era.