Prognostic significance of POD24 in Primary central nervous system diffuse large B-cell lymphoma: A Retrospective Study

Objective Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare form of non-Hodgkin lymphoma with a notably poor prognosis. This study aimed to identify new prognostic factors for improved prognostic stratification in PCNS-DLBCL. Methods A total of 85 PCNS-DLBCL cases from three hospitals were retrospectively analyzed. Disease progression within 24 months (POD24) and its risk factors were investigated, and a prognostic model for predicting POD24 was constructed. Results The median overall survival (mOS) and median progression-free survival (mPFS) for the entire cohort were 48.54 months and 39.09 months, respectively. Survival analysis indicated that age ≥ 65 years (HR = 4.05, P  = 0.008), non-responsive disease (HR = 4.43, P  = 0.004), and POD24 (HR = 25.22, P  = 0.002) were independent poor prognostic factors for OS in PCNS-DLBCL. Further analysis revealed that independent risk factors for POD24 included elevated serum lactate dehydrogenase (LDH) levels (OR = 12.00, P  = 0.03), elevated triglycerides (TG, OR = 4.88, P  = 0.047), and non-responsive disease (OR = 9.39, P  = 0.003). Subsequently, an “LDH-TG-Efficacy (LTE)” prognostic model for PCNS-DLBCL was constructed. The incidence of POD24 was significantly higher in the “LTE” high-risk group (≥ 1 point) compared to the low-risk group (0 points) (81.8% vs. 35%, P < 0.001). The receiver operating characteristic (ROC) curve determined that the area under the curve (AUC) for the “LTE” model was 0.828 (95% CI: 0.7282–0.927), with a sensitivity and specificity of 79.4% and 79.3%, respectively. Additionally, the prognosis of the “LTE” high-risk group was significantly worse. Conclusion POD24 is a potent prognostic factor for accurate risk assessment in patients with PCNS-DLBCL, and the “LTE” prognostic index may provide a reference for better identifying populations at risk for POD24.