Overview
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive subtype of extranodal B-cell lymphoma with no standardized care pathway. This study characterized clinical characteristics, treatment patterns, and outcomes among 2,792 patients diagnosed with PCNSL in the US Flatiron Health Research Database, comprising over 82,000 patients with large B-cell lymphoma, between 2011 and 2026.
High-dose methotrexate (HD-MTX)-based regimens were the predominant first-line induction approach, received by 41% of patients as HD-MTX ± rituximab. Documented consolidation was infrequent overall (15% radiation, 9.4% stem cell transplant [HCT], 7.9% high-dose cytarabine). Median real-world progression-free survival and overall survival were 25.4 months and 60.5 months, respectively. Intensive induction and consolidative HCT were associated with longer survival outcomes, though these strategies were more commonly utilized among younger patients and within academic medical centers.
Why this matters
This research provides a real-world benchmark for PCNSL care across US community and academic oncology practices, highlighting substantial variability in induction and consolidation approaches. The findings emphasize the need for continued investigation into risk stratification and optimal treatment intensity in this rare patient population.