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Delayed neurotoxicity in primary central nervous system lymphoma
Omuro AM, Ben-Porat LS, Panageas KS, Kim AK, Correa DD, Yahalom J, Deangelis LM, Abrey LE.. Archives of neurology, 2005-10-01
Topic: Brain proteins, microglia and lab models
Background Treatment for primary central nervous lymphoma (PCNSL) with chemotherapy and radiotherapy has resulted in improved survival, but some patients develop neurologic deterioration that represents a treatment-related toxic effect. This delayed neurotoxicity has been poorly defined in the literature, and the underlying mechanisms are unknown. Objective To describe the clinical findings, time course, and pathophysiologic mechanisms associated with neurotoxicity in an attempt to generate hypotheses for future studies that address prevention and treatment of this complication of successful PCNSL therapy. Design Retrospective review. Setting Department of Neurology, Memorial Sloan-Kettering Cancer Center. Patients One hundred eighty-five patients treated for PCNSL, including 43 who developed neurotoxicity. Main outcome measures Potential risk factors, clinical course, and neuropsychological, neuroimaging, and histologic findings. Results The 5-year cumulative incidence of neurotoxicity was 24%; this incidence increases over time. Neurotoxicity presented as a rapidly progressive subcortical dementia characterized by psychomotor slowing, executive and memory dysfunction, behavioral changes, gait ataxia, and incontinence. Imaging findings revealed diffuse white matter disease and cortical-subcortical atrophy. Available autopsy data showed white matter damage with gliosis, thickening of small vessels, and demyelination. Statistical analyses were performed, accounting for death as a competing risk. Older age (P = .01), mental status changes at diagnosis (P = .04), female sex (P = .05), and radiotherapy (P Conclusion These findings suggest that the core pathophysiologic mechanism is the interruption of frontal-subcortical circuits mediated by radiation damage, possibly caused by progressive microvascular alterations, loss of oligodendrocyte progenitors, or oxidative stress.
Key findings
- Objective To describe the clinical findings, time course, and pathophysiologic mechanisms associated with neurotoxicity in an attempt to generate hypotheses for future studies that address prevention and treatment of this complication of successful PCNSL therapy.
- Results The 5-year cumulative incidence of neurotoxicity was 24%; this incidence increases over time.
- Imaging findings revealed diffuse white matter disease and cortical-subcortical atrophy.
- Older age (P = .01), mental status changes at diagnosis (P = .04), female sex (P = .05), and radiotherapy (P<.001) predicted neurotoxicity on univariate analysis, but only radiotherapy remained significant in the multivariate setting.
Why it matters
This retrospective review describes delayed neurotoxicity, including a rapidly progressive subcortical dementia, in patients treated for primary central nervous system lymphoma. It aims to generate hypotheses for future studies on preventing and treating this complication of successful lymphoma therapy, not Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | 3 / 4 | Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2005 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 286 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.4 citations a year over 23 year(s) since 2005 |
| Impact for its field and year | 3 / 6 | Cited 7.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 32 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Lauren E. Abrey: h-index 83 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Memorial Sloan Kettering Cancer Center: institution h-index 1,931 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16216945) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 42 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Omuro, A. M., Ben-Porat, L. S., Panageas, K. S., Kim, A. K., Correa, D. D., Yahalom, J., et al. (2005). Delayed neurotoxicity in primary central nervous system lymphoma. Archives of neurology. https://doi.org/10.1001/archneur.62.10.1595
Vancouver
Omuro AM, Ben-Porat LS, Panageas KS, Kim AK, Correa DD, Yahalom J, et al. Delayed neurotoxicity in primary central nervous system lymphoma. Archives of neurology. 2005. doi:10.1001/archneur.62.10.1595. PMID: 16216945.
BibTeX
@article{omuro2005-16216945,
author = {Omuro, A. M. and Ben-Porat, L. S. and Panageas, K. S. and Kim, A. K. and Correa, D. D. and Yahalom, J. and Deangelis, L. M. and Abrey, L. E.},
title = {{Delayed neurotoxicity in primary central nervous system lymphoma}},
journal = {Archives of neurology},
year = {2005},
doi = {10.1001/archneur.62.10.1595},
pmid = {16216945},
url = {https://doi.org/10.1001/archneur.62.10.1595}
}
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