Primary central nervous system lymphoma in children: Insights from the three-year experience at the largest public-sector pediatric oncology center in Pakistan.
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OBJECTIVE: Primary CNS lymphoma (PCNSL) in children is a rare disease, and this study aimed to document the experience of dealing with this in our geographical and resource settings. METHODOLOGY: It was an ambidirectional cohort study conducted at the Department of Pediatric Hematology/Oncology and the Department of Pediatric Neurosurgery at the University of Child Health Sciences, The Children's Hospital Lahore, Pakistan from March 2024 to December 2024. This study included seven suspected and confirmed cases of PCNSL in children under the age of 16 years who presented to a public-sector specialized center in Pakistan over the three-year study period. RESULTS: A total of seven cases of suspected PCNSL were included in the study. The median age at presentation was eight years, with a female-to-male ratio of 2.5:1. Most commonly presenting with a focal neurological deficit, with a median duration of symptoms of 12 weeks, and a median Lansky performance score of 50. Only 57% (04) of patients underwent surgical resection followed by adjuvant chemotherapy. Overall, 57% (03) of patients died, 29% (02) were lost to follow-up, and only 14% (01) are under treatment. CONCLUSION: PCNSL in children is equally rare in our part of the world, but has a dismal survival rate. Timely surgical intervention, improved supportive care, and a reduction in treatment abandonment might improve the prognosis.