Results of a new study demonstrated that the risk of cardiovascular death (CVD) in patients with primary central nervous system lymphoma (PCNSL) was lower than it was in patients with extra-central nervous system lymphoma (ECNSL), but actual CVD risk in patients with PCNSL is uncertain. Results of the study were published in the journal Frontiers in Oncology.1

In this retrospective study, patient clinical data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program database. Risk factors for CVD were evaluated and compared between patients with PCNSL and ECSNL, with propensity score-matching to aid in the balancing of baseline characteristics.

A total of 4038 patients with PCNSL and 246,760 patients with ECSNL were included in this analysis. Fatalities in patients with PCNSL primarily were attributed to cancer-related causes (86.9%). Among the 13.1% of fatalities unrelated to cancer, CVD was the most common cause of noncancer death, contributing to 41.2% of these noncancer deaths. This occurred most frequently during the first year following diagnosis.

Risk factors for CVD in patients with PCNSL were age older than 60 years and diagnosis during the years 2000 to 2008; age older than 60 years was associated with a 2.8-fold greater risk of CVD (hazard ratio [HR], 2.833; 95% CI, 1.857-4.323; P <.001). Diagnosis during the years 2009 through 2016 showed an HR of 0.592 (95% CI, 0.409-0.858; P =.006). Chemotherapy and radiotherapy were not found to be risk factors for CVD in patients with this diagnosis when evaluated using multivariate analysis.

CVD risk in patients with PCNSL was approximately 40% lower than it was in patients with ECNSL, which the study authors in part considered potentially related to treatment characteristics, in addition to other possible causes.

The study authors cautioned that clinicians should be attentive to CVD risk in patients who have PCNSL, particularly during the initial year following diagnosis in patients older than 60. “More clinical trials are required to further inspect the risk of CVD in the patients with PCNSL,” the study authors concluded.


Qiu Z, Tang Y, Jiang Y, et al. Cardiovascular outcomes in the patients with primary central nervous system lymphoma: a multi-registry based cohort study of 4,038 cases. Front Oncol. 2021;11:691038. doi:10.3389/fonc.2021.691038