Late relapse in primary central nervous system lymphoma: Clonal persistence Academic Article uri icon


MeSH Major

  • Antimetabolites, Antineoplastic
  • Central Nervous System Neoplasms
  • Lymphoma
  • Methotrexate
  • Neoplasm Recurrence, Local
  • Salvage Therapy


  • Recurrence of primary central nervous system lymphoma (PCNSL) after initial diagnosis and treatment occurs within 2 years in most patients, and relapse after 5 years is rare. We evaluated late relapse in our PCNSL population. We identified 10 patients from our database of 378 patients (268 achieved a complete response and 230 had relapse) with PCNSL who had relapse ≥5 years after initial diagnosis. At initial diagnosis, their median age was 47 years; all patients had brain involvement and achieved a complete response to initial therapy (9 received high-dose methotrexate). Median time to first relapse was 7.4 years (range, 5.2-14.6 y). Eight patients had relapse in the brain, 1 had ocular relapse, and 1 had a systemic relapse. The histologic specimens at initial diagnosis and relapse were examined for clonal rearrangement in 3 patients; 1 had the identical clone at initial diagnosis and relapse 13.8 years later, and the other 2 were uninformative. All patients received salvage therapy (9 received systemic therapy and 1 received intraocular chemotherapy. Nine patients achieved a complete response to salvage therapy and 1 achieved a partial response. Four patients had relapse a second time. The median progression-free survival after first relapse was 31 months (range, 7.9-82.4). Late relapses accounted for 4% of all recurrences (10 of 230 patients) in our PCNSL population. Long-term persistence of the PCNSL clone was observed in one patient. Patients with late relapses have a good response to salvage therapy and prolonged survival.

publication date

  • May 2011



  • Academic Article



  • eng

PubMed Central ID

  • PMC3093334

Digital Object Identifier (DOI)

  • 10.1093/neuonc/nor014

PubMed ID

  • 21372070

Additional Document Info

start page

  • 525

end page

  • 9


  • 13


  • 5