PP78. Primary CNS Lymphoma Outcomes in a Single Centre: A 7 Year Study

INTRODUCTION: Primary CNS Lymphoma (PCNSL) in the immunocompetent population is reported as comprising 3–5% of all primary CNS neoplasms. They are considered aggressive tumours and their management remains controversial. We report a single centre experience of PCNSL over 7 years. METHODS: This is a retrospective cohort study of all biopsy confirmed PCNSLs between 2009 and 2016 in a busy London neurosurgical unit. Data was sourced from the lymphoma database, pathology reports, patient notes and radiology. We then reviewed their oncology treatment and outcomes. Primary endpoints were mortality, relapse and treatment complication rates. RESULTS: We had 58 patients (35 males and 23 females). 13 (22.4%) had a previous history of cancer and 10(17.2%) were immunocompromised. The rate of mortality during the seven years was 58.6% (34/58). The mean survival was 1.9 years (11 days to 7.16 years) Biopsies for tissue diagnosis had a low complication rate in our cohort (1 patient with biopsy related intracranial haematoma; 1 patient with wound breakdown). We were able to review treatment plans of 30 patients of whom 19 underwent chemotherapy and 10 had palliative radiotherapy only. 3 patients were not fit for either chemotherapy or radiotherapy. Neutropenic sepsis occurred in 26.1% (6/30) of the treated group with a similar proportion having neurological problems such as short term memory loss, seizures and hydrocephalus. 21.7% (5/30) had relapse despite treatment. CONCLUSIONS: 40% of our cohort had a history of cancer or being immunocompromised which can be attributed to the presence of activated oncogenes and failure of cell cycle repair mechanisms. A significant proportion (21.7% in our cohort) had relapse despite treatment which supports previous studies of PCNSL as an aggressive disease. It remains a disease with a high mortality and significant complications during treatment