Cargando…
MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma
INTRODUCTION: To assess the value of the Mini-Mental State Examination (MMSE)-score at baseline in predicting survival in adult primary central nervous system lymphoma (PCNSL) patients. METHODS: In the HOVON 105/ ALLG NHL 24 phase III study patients with newly-diagnosed PCNSL were randomized between...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997829/ https://www.ncbi.nlm.nih.gov/pubmed/33611761 http://dx.doi.org/10.1007/s11060-021-03708-8 |
_version_ | 1783670413800243200 |
---|---|
author | van der Meulen, Matthijs Dirven, Linda Bakunina, Katerina van den Bent, Martin J. Issa, Samar Doorduijn, Jeanette K. Bromberg, Jacoline E. C. |
author_facet | van der Meulen, Matthijs Dirven, Linda Bakunina, Katerina van den Bent, Martin J. Issa, Samar Doorduijn, Jeanette K. Bromberg, Jacoline E. C. |
author_sort | van der Meulen, Matthijs |
collection | PubMed |
description | INTRODUCTION: To assess the value of the Mini-Mental State Examination (MMSE)-score at baseline in predicting survival in adult primary central nervous system lymphoma (PCNSL) patients. METHODS: In the HOVON 105/ ALLG NHL 24 phase III study patients with newly-diagnosed PCNSL were randomized between high-dose methotrexate-based chemotherapy with or without rituximab. Data on potential (MMSE-score), and known baseline prognostic factors (age, performance status, serum LDH, cerebrospinal fluid total protein, involvement of deep brain structures, multiple cerebral lesions, and the IELSG-score) were collected prospectively. Multivariable stepwise Cox regression analyses were used to assess the prognostic value of all factors on progression-free survival (PFS) and overall survival (OS) among patients with available MMSE score at baseline. Age was analyzed as continuous variable, the MMSE-score both as a continuous and as a categorical variable. RESULTS: In univariable analysis, age, MMSE-score and whether the patient received rituximab were statistically significantly prognostic factors for PFS. Age and MMSE-score were statistically significantly associated with OS. In a multivariable analysis of the univariately significant factors only MMSE-score was independently associated with the survival endpoints, as a continuous variable (HR for PFS 1.04, 95% CI 1.01–1.08; OS 1.06 (95% CI 1.02–1.10) and as categorical variable HR (< 27 versus ≥ 27 for PFS 1.55 (1.02–2.35); OS 1.68 (1.05–2.70). In our population, performance status, serum LDH, and CSF protein level were not of prognostic value. CONCLUSION: Neurocognitive disturbances, measured with the MMSE at baseline, are an unfavorable prognostic factor for both PFS and OS in adult PCNSL patients up to 70 years-old. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-021-03708-8. |
format | Online Article Text |
id | pubmed-7997829 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-79978292021-04-16 MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma van der Meulen, Matthijs Dirven, Linda Bakunina, Katerina van den Bent, Martin J. Issa, Samar Doorduijn, Jeanette K. Bromberg, Jacoline E. C. J Neurooncol Clinical Study INTRODUCTION: To assess the value of the Mini-Mental State Examination (MMSE)-score at baseline in predicting survival in adult primary central nervous system lymphoma (PCNSL) patients. METHODS: In the HOVON 105/ ALLG NHL 24 phase III study patients with newly-diagnosed PCNSL were randomized between high-dose methotrexate-based chemotherapy with or without rituximab. Data on potential (MMSE-score), and known baseline prognostic factors (age, performance status, serum LDH, cerebrospinal fluid total protein, involvement of deep brain structures, multiple cerebral lesions, and the IELSG-score) were collected prospectively. Multivariable stepwise Cox regression analyses were used to assess the prognostic value of all factors on progression-free survival (PFS) and overall survival (OS) among patients with available MMSE score at baseline. Age was analyzed as continuous variable, the MMSE-score both as a continuous and as a categorical variable. RESULTS: In univariable analysis, age, MMSE-score and whether the patient received rituximab were statistically significantly prognostic factors for PFS. Age and MMSE-score were statistically significantly associated with OS. In a multivariable analysis of the univariately significant factors only MMSE-score was independently associated with the survival endpoints, as a continuous variable (HR for PFS 1.04, 95% CI 1.01–1.08; OS 1.06 (95% CI 1.02–1.10) and as categorical variable HR (< 27 versus ≥ 27 for PFS 1.55 (1.02–2.35); OS 1.68 (1.05–2.70). In our population, performance status, serum LDH, and CSF protein level were not of prognostic value. CONCLUSION: Neurocognitive disturbances, measured with the MMSE at baseline, are an unfavorable prognostic factor for both PFS and OS in adult PCNSL patients up to 70 years-old. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-021-03708-8. Springer US 2021-02-21 2021 /pmc/articles/PMC7997829/ /pubmed/33611761 http://dx.doi.org/10.1007/s11060-021-03708-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Study van der Meulen, Matthijs Dirven, Linda Bakunina, Katerina van den Bent, Martin J. Issa, Samar Doorduijn, Jeanette K. Bromberg, Jacoline E. C. MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma |
title | MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma |
title_full | MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma |
title_fullStr | MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma |
title_full_unstemmed | MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma |
title_short | MMSE is an independent prognostic factor for survival in primary central nervous system lymphoma |
title_sort | mmse is an independent prognostic factor for survival in primary central nervous system lymphoma |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997829/ https://www.ncbi.nlm.nih.gov/pubmed/33611761 http://dx.doi.org/10.1007/s11060-021-03708-8 |
work_keys_str_mv | AT vandermeulenmatthijs mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma AT dirvenlinda mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma AT bakuninakaterina mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma AT vandenbentmartinj mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma AT issasamar mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma AT doorduijnjeanettek mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma AT brombergjacolineec mmseisanindependentprognosticfactorforsurvivalinprimarycentralnervoussystemlymphoma |