MRI Predictors of Outcome in Primary Central Nervous System Lymphoma Patients Before and After Autologous Stem Cell Transplant

Introduction: Primary CNS lymphoma (PCNSL) is treated with intensive chemotherapy and autologous stem cell transplant (HDT-ASCT), yet up to one-third of patients relapse. Standard MRI response criteria may not reliably distinguish residual tumour from post-treatment change; additional MRI sequences, such as apparent diffusion coefficient (ADC), could assist in the determination of early relapses, although their prognostic value remains uncertain. Methods: We retrospectively analysed 63 PCNSL patients, assessed pre-HDT-ASCT IPCG response and ADC values, and examined associations with 2-year relapse-free survival. Results: = 0.005). An overall CR rate of 85% was observed at a median follow-up of 24.7 months. Conclusions: Pre-HDT-ASCT IPCG status, not ADC values, predicts 2-year IPCG status in PCNSL patients.