{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:48:43Z","timestamp":1791920923471,"version":"4.3.4"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"1","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background.<\/jats:title><jats:p>The optimal therapeutic approach for patients with AIDS-related primary central nervous system lymphoma (AR-PCNSL) remains undefined. While its incidence declined substantially with combination antiretroviral therapy (cART), AR-PCNSL remains a highly aggressive neoplasm for which whole brain radiotherapy (WBRT) is considered a standard first-line intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>To identify therapy-related factors associated with favorable survival, we first retrospectively analyzed outcomes of AR-PCNSL patients treated at San Francisco General Hospital, a public hospital with a long history of dedicated care for patients with HIV and AIDS-related malignancies. Results were validated in a retrospective, multicenter analysis that evaluated all newly diagnosed patients with AR-PCNSL treated with cART plus high-dose methotrexate (HD-MTX).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>We provide evidence that CD4+ reconstitution with cART administered during HD-MTX correlates with long-term survival among patients with CD4 &amp;lt;100. This was confirmed in a multicenter analysis which demonstrated that integration of cART regimens with HD-MTX was generally well tolerated and resulted in longer progression-free survival than other treatments. No profound differences in immunophenotype were identified in an analysis of AR-PCNSL tumors that arose in the pre- versus post-cART eras. However, we detected evidence for a demographic shift, as the proportion of minority patients with AR-PCNSL increased since advent of cART.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Long-term disease-free survival can be achieved in AR-PCNSL, even among those with histories of opportunistic infections, limited access to health care, and medical non-adherence. Given this, as well as the long-term toxicities of WBRT, we recommend that integration of cART plus first-line HD-MTX be considered for all patients with AR-PCNSL.<\/jats:p><\/jats:sec>","DOI":"10.1093\/neuonc\/now155","type":"journal-article","created":{"date-parts":[[2016,8,31]],"date-time":"2016-08-31T02:23:18Z","timestamp":1472610198000},"page":"99-108","source":"Crossref","is-referenced-by-count":59,"title":["Long-term survival in AIDS-related primary central nervous system lymphoma"],"prefix":"10.1093","volume":"19","author":[{"given":"Neel K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Nolan","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Omuro","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin G.","family":"Reid","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Ching","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Mannis","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Jaglal","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C.","family":"Chavez","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Griffin","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology\/Oncology, University of California, San Diego (E.G.R.); Division of Hematolo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald 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