Clinical Features and Prognostic Factors for Primary Anaplastic Large Cell Lymphoma of the Central Nervous System: A Systematic Review
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Selection
2.2. Data Extraction
2.3. Statistical Analysis
3. Results
3.1. Clinical Features of Primary ALCL of the CNS
3.2. Factors Associated with the Prognosis for Primary ALCL of the CNS
4. Discussion
4.1. Patient Background
4.2. Diagnosis
4.3. ALK Positivity
4.4. Chemotherapy
4.5. Prognosis
4.6. Summary
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Cases | Authors | Year | Age | Sex | ALK Status | Location | Lesion | Meningeal | Surgery | Marker | MTX | RT | Survival | Initial Symptom/s | Primary Diagnosis | First Therapy |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Havlioglu et al. [7] | 1995 | 4 | F | positive | multifocal brain, brain stem, spinal cord | M | + | biopsy | null | - | + | NED at 6.1 years | headache, nausea, vomiting, neck stiffness | mycobacterial | anti-TB |
2 | Buxton et al. [8] | 1998 | 10 | F | positive | parietal lobe abutting against falx | S | + | resection | T | + | + | dead at 6 months following CT | sensory disturbance | ND | surgery |
3 | Abdulkader et al. [9] | 1999 | 13 | M | positive | frontal and parietal | M | + | biopsy | T | + | - | dead shortly after CT | headache, vomiting | mycobacterial | anti-TB |
4 | Ponzoni et al. [10] | 2002 | 29 | M | positive | frontal and temporal | M | + | biopsy | T | + | + | NED at 13 months | fever, headache, seizures | meningitis | antibiotics |
5 | George et al. [11] | 2003 | 17 | M | positive | parietal dura | S | + | ND | T | - | + | NED at 4.8 years | ND | ND | ND |
6 | George et al. [11] | 2003 | 18 | F | positive | temporal lobe, dura mater | M | + | ND | T | + | + | NED at 5.2 years | ND | ND | ND |
7 | Rupani et al. [12] | 2005 | 17 | M | positive | frontal and parietal lobe invading scapura | M | + | biopsy | T | - | + | dead at 1 month | headache, upper limb hemiparesis, partial seizures | mycobacterial | anti-TB |
8 | Cooper et al. [13] | 2006 | 39 | M | positive | occipital and parietal | S | - | biopsy | T | + | + | NED at 9 months | seizures | headaches | none |
9 | Carmichael et al. [14] | 2007 | 38 | M | positive | parietal, occipital | S | ND | biopsy | T | + | + | NED at 15 months | seizure, syncope, hemiparesis, visual field deficit, ataxia | glioblastoma or PCNSL | WBRT |
10 | Karikari et al. [15] | 2007 | 4 | M | positive | pineal, frontal, parietal | M | + | biopsy | T | - | + | NED after CT | seizures, altered mental status | meningitis | antibiotics |
11 | Merlin et al. [16] | 2008 | 13 | M | positive | frontal dura | S | + | biopsy | ND | + | + | dead at 2 years | headache, nausea | meningitis | CRT |
12 | Ozkaynak et al. [17] | 2009 | 9 | M | positive | bilateral frontal | M | ND | partial resection | T | + | + | NED at 26 months | altered mental status | meningitis | antibiotics |
13 | Shah et al. [18] | 2010 | 1 | M | positive | dura mater | S | + | partial resection | T | + | - | NED at 9 years | progressive lethargy, motor function loss. | ALCL | chemo |
14 | Vivekanandan et al. [19] | 2011 | 20 | M | positive | sylvian fissure | S | + | resection | T | - | + | NED at 8 years | seizures | ALCL | CRT |
15 | Kim et al. [20] | 2013 | 30 | M | positive | parietal and occipital dura | S | + | resection | T | + | + | NED at 16 months | headache | meningioma or PCNSL | surgery, CRT |
16 | Nomura et al. [21] | 2013 | 20 | M | positive | frontal | S | ND | resection | T | + | - | NED at 5 years | seizures | high grade glioma | surgery, chemo |
17 | Park et al. [22] | 2013 | 31 | M | positive | leptomeningeal | S | + | biopsy | T | + | - | NED at 18 months | altered mental status, headache | meningitis | antibiotics |
18 | Dunbar et al. [23] | 2014 | 10 | M | positive | frontal | S | + | biopsy | T | + | - | NED at 3 years | aphasia, hemiparesis | meningitis | antibiotics |
19 | Furuya et al. [24] | 2014 | 11 | M | positive | parietal | S | + | biopsy | null | + | + | NED at 8 years | headache, nausea | meningitis | antibiotics |
20 | Geetha et al. [25] | 2014 | 19 | M | positive | cerebellum | S | ND | partial resection | ND | + | - | dead at 10 months | headache, vomiting | tumor | surgery |
21 | Kuntegowdenahalli et al. [26] | 2015 | 18 | M | positive | parietal, occipital | S | + | resection | T | + | + | NED after CT | fever, headache, seizures | tumor | surgery, CRT |
22 | Dong et al. [27] | 2016 | 34 | M | positive | spinal cord | M | + | biopsy | null | + | + | NED at 2 years | headache, diplopia, vomiting | mycobacterial | anti-TB |
23 | Splavski et al. [28] | 2016 | 26 | M | positive | intraventricular | S | - | resection | T | + | + | NED at 2 years | diplopia, ptosis | tumor | surgery |
24 | Kaku et al. [29] | 2017 | 21 | M | positive | frontoparietal | S | + | resection | T | + | + | NED at 2 years | headache, seizures, fever | tumor | surgery |
25 | Feng et al. [30] | 2020 | 8 | M | positive | parietal | S | + | CSF | T | - | - | dead at 8 weeks | cognitive impairment, dizziness, vomiting, fever, convulsions | viral encephalitis | antibiotics |
26 | Hirano et al. [31] | 2020 | 26 | M | positive | occipital dura | S | + | resection | T | + | - | NED at 5 months | headache, blurry vision | meningioma | surgery |
27 | Lee et al. [32] | 2020 | 12 | M | positive | parietal | S | + | resection | null | + | - | NED at 16 months | headache, seizures | PCNSL or meningioma | surgery |
28 | Liu Q et al. [33] | 2020 | 12 | M | positive | occipital, falx | M | + | biopsy | null | - | - | dead at 1 month | headache, vomiting | tumor | none |
29 | Paulus et al. [34] | 1994 | 63 | M | negative | parietal and frontal | M | - | biopsy | T | - | + | dead at 11 weeks | ND | tumor | surgery |
30 | Chuang et al. [35] | 2001 | 46 | F | negative | parietooccipital | S | + | resection | T | - | + | NED at 25 months | headache, hemiparesis, blurry vision | tumor | surgery |
31 | George et al. [11] | 2003 | 22 | F | negative | dura cerebellum, temporal, 4 additional lesions | M | - | ND | T | - | - | dead at 11 days | ND | ND | ND |
32 | George et al. [11] | 2003 | 50 | M | negative | parietal, 2 additional supratentorial, dura | M | + | ND | null | - | + | dead at 2 months | ND | ND | ND |
33 | Gonzales et al. [36] | 2003 | 82 | M | negative | posterior fossa attaching to tentorium | S | + | ND | T | - | - | dead at 6 weeks | ND | ND | ND |
34 | Tajima et al. [37] | 2003 | 52 | F | negative | frontal | M | - | biopsy | null | + | + | NED (lesions markedly decreased) | hemiparesis | leukoenchephalopathy | biopsy |
35 | Rowsell et al. [38] | 2004 | 46 | M | negative | occipital | S | + | resection | T | - | + | dead at 2 months | ataxia | tumor | surgery |
36 | Kodama et al. [39] | 2009 | 79 | M | negative | parietoocipital | S | - | resection | T | - | - | dead at 8 months | dementia-like symptoms | tumor | surgery |
37 | Colen et al. [40] | 2010 | 65 | M | negative | temporal | S | + | resection | T | + | + | NED after 2 courses of CT | headache, blurry vision | meningioma | surgery |
38 | Sugino et al. [41] | 2012 | 75 | M | negative | bilateral hemisphere | M | - | biopsy | T | - | + | dead at 8 months | memory loss | tumor | biopsy |
39 | Lannon M et al. [42] | 2020 | 63 | M | negative | intracranial and intraspinal | M | + | resection | T | + | - | NED at 18 months | leg weakness | sarcoidosis or lymphoma | steroids |
Variables | Primary ALCL of the CNS | Primary ALK-Positive ALCL of the CNS | Primary ALK-Negative ALCL of the CNS | p-Value |
---|---|---|---|---|
Incidence | 39 cases reported | 28 cases reported | 11 cases reported | - |
Median age | 21 (1–82) | 17.5 (1–39) | 63 (22–82) | <0.01 |
Female to male ratio | 0.18 | 0.12 | 0.38 | 0.324 |
Multiple lesions | 15 (38%) | 9 (32%) | 6 (55%) | 0.277 |
Meningeal involvement | 31 (80%) | 25 (92%) | 6 (55%) | 0.028 |
Immunodeficiency | 1 (3%) | 0 (0%) | 1 (9%) | 0.282 |
MTX-based chemotherapy | 24 (62%) | 21 (75%) | 3 (27%) | 0.010 |
Radiation therapy | 25 (64%) | 18 (64%) | 7 (64%) | 1.000 |
Prognosis | 58% (2-year survival) | 71% (2-year survival) | 22% (2-year survival) | - |
Median survival time | Not reached | Not reached | 0.21 years | - |
Variables | HR (95% CI) | p-Value |
---|---|---|
Age < 40 years | 0.32 (0.11–0.95) | 0.039 |
Female sex | 1.00 (0.22–4.49) | 0.998 |
ALK positive | 0.24 (0.08–0.71) | 0.010 |
Multiple lesions | 2.23 (0.78–6.37) | 0.135 |
Meningeal lesions | 0.51 (0.16–1.67) | 0.265 |
Tumor resection * | 0.47 (0.14–1.60) | 0.226 |
MTX-based chemotherapy | 0.17 (0.05–0.56) | 0.003 |
Radiotherapy | 0.49 (0.17–1.41) | 0.189 |
Variables | HR (95% CI) | p-Value |
---|---|---|
Female sex | 1.16 (0.14–9.67) | 0.891 |
Multiple lesions | 2.01 (0.45–9.04) | 0.362 |
Meningeal lesions | N/A | N/A |
Tumor resection * | 0.39 (0.08–2.01) | 0.260 |
MTX-based chemotherapy | 0.34 (0.07–1.53) | 0.160 |
Radiotherapy | 0.35 (0.08–1.59) | 0.175 |
Patient Background
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Diagnosis
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Treatment
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Prognosis
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Hirano, Y.; Miyawaki, S.; Tanaka, S.; Taoka, K.; Hongo, H.; Teranishi, Y.; Takami, H.; Takayanagi, S.; Kurokawa, M.; Saito, N. Clinical Features and Prognostic Factors for Primary Anaplastic Large Cell Lymphoma of the Central Nervous System: A Systematic Review. Cancers 2021, 13, 4358. https://doi.org/10.3390/cancers13174358
Hirano Y, Miyawaki S, Tanaka S, Taoka K, Hongo H, Teranishi Y, Takami H, Takayanagi S, Kurokawa M, Saito N. Clinical Features and Prognostic Factors for Primary Anaplastic Large Cell Lymphoma of the Central Nervous System: A Systematic Review. Cancers. 2021; 13(17):4358. https://doi.org/10.3390/cancers13174358
Chicago/Turabian StyleHirano, Yudai, Satoru Miyawaki, Shota Tanaka, Kazuki Taoka, Hiroki Hongo, Yu Teranishi, Hirokazu Takami, Shunsaku Takayanagi, Mineo Kurokawa, and Nobuhito Saito. 2021. "Clinical Features and Prognostic Factors for Primary Anaplastic Large Cell Lymphoma of the Central Nervous System: A Systematic Review" Cancers 13, no. 17: 4358. https://doi.org/10.3390/cancers13174358