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Combined treatment of primary vitreoretinal lymphomas significantly prolongs the time to first relapse
  1. Aneta Klimova1,
  2. Jarmila Heissigerova1,
  3. Eva Rihova1,
  4. Michaela Brichova1,
  5. Robert Pytlik2,
  6. Ivan Spicka2,
  7. Katerina Mrazova3,
  8. Jana Karolova2,
  9. Petra Svozilkova1
  1. 1Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
  2. 2First Department of Medicine—Department of Haematology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
  3. 3Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
  1. Correspondence to Dr Aneta Klimova, Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic ; aneta.klimova{at}volny.cz

Abstract

Background Vitreoretinal lymphomas belong to the family of central nervous system (CNS) lymphomas. The optimal approach for the treatment of isolated primary vitreoretinal lymphoma is unclear because of the lack of large comparative clinical series. Combination of intravitreal and systemic chemotherapy is recommended in many reports. The aim of our retrospective study was to compare the survival rate and prognosis of patients with vitreoretinal lymphoma with and without CNS involvement.

Methods Twenty patients with vitreoretinal lymphomas were observed between the years 2004and2016, 10 patients with primary vitreoretinal lymphoma and 10 with primary CNS lymphoma. To compare survival rates, we included 53 patients diagnosed with primary CNS lymphoma without vitreoretinal involvement between the years 2002and2011 from our haemato-oncology department.

Results The 5-year survival rate was estimated 71% in patients with vitreoretinal lymphoma in our observation. Significantly longer 5-year overall survival (P˂0.01) was observed in patients with vitreoretinal lymphoma compared with patients with primary CNS lymphoma without vitreoretinal involvement. Progression-free survival was almost equal in both groups of patients with primary vitreoretinal lymphoma and primary CNS lymphoma (P=0.363). The relapse of lymphoma was frequent (50%–60%) with the median time to first relapse of 31 months. Combined treatment (local and systemic) in patients without CNS involvement significantly prolonged progression-free survival in our study (P˂0.05).

Conclusion Combined treatment of primary vitreoretinal lymphoma significantly delays the relapse of lymphoma compared with local therapy alone. Intraocular involvement brings significant positive prognostic value when overall survival is compared.

  • neoplasia
  • treatment medical

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Footnotes

  • Contributors AK: corresponding author, data collection, data analysis and interpretation, drafting the article. JH, PS and RP: conception and design of the work and critical revision of the article, final approval of the version to be published. ER and MB: data analysis and interpretation. IS, KM and JK: data collection.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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