Genetic alterations and prognostic factors for primary central nervous system lymphoma treated with R-MPV-A combination immunochemotherapy

2016 Fiscal Year Final Research Report

• Project/Area Number: 26462189
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurosurgery
• Research Institution: Kyorin University
• Principal Investigator: Shiokawa Yoshiaki 杏林大学, 医学部, 教授 (20245450)
• Co-Investigator(Renkei-kenkyūsha): NAGANE Motoo 杏林大学, 医学部, 教授 (60327468)
• Research Collaborator: SASAKI Nobuyoshi ; LEE Jeunghun ; SHIMIZU Saki ; SUZUKI Kaori
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 脳腫瘍 / 中枢神経系悪性リンパ腫 / 遺伝子異常 / MGMT / MYD88 / MMSE

Outline of Final Research Achievements

Primary central nervous system lymphoma (PCNSL) is one of the deadly malignant brain tumors, but exhibits a high response to combination immunochemotherapy with rituximab, methotrexate, procarbazine, vincristine and cytarabine (R-MPV-A). We analyzed 32 patients with newly diagnosed PCNSL composed of diffuse large B cell lymphoma (DLBCL) for potential genetic alterations as well as prognostic factors for progression-free survival (PFS). We found MYD88 mutations in 70% of patients which is much higher than in those with systemic DLBCL, while MGMT promoter was methylated in 60% of cases. Factors associated with longer PFS are age<70 years (p=0.059), single lesion (p=0.010), methylated MGMT promoter (p=0.056), and MMSE score ≧ 24 (p=0.025), but MYD88 mutations did not affect outcome (p=0.186, rather mutated MYD88 patients tended to live longer). These results suggest that methylated MGMT and high baseline MMSE score might predict higher benefit and better outcome with R-MPV-A treatment.

Free Research Field

脳腫瘍