Concurrent CNS tumors and multiple sclerosis: retrospective single-center cohort study and lessons for the clinical management

  • Introduction: The concurrent presence of both central nervous system (CNS) tumors and multiple sclerosis (MS) poses various diagnostic and therapeutic pitfalls and makes the clinical management of such patients challenging. Methods: In this retrospective, single-center cohort study, we searched our clinical databases (2006–2019) for patients with concurrent CNS tumors and MS and described their disease courses. Age at diagnosis of the respective disease and probabilities for MS disease activity events (DAEs) with vs. without prior tumor-specific therapy were tested pairwise using t-test for dependent samples and exact binomial test. Results: N = 16 patients with concurrent CNS tumors and MS were identified. MS diagnosis preceded the CNS oncological diagnosis by an average of 9 years (p = 0.004). More DAEs occurred in patients without prior chemotherapy (83.3%) than in patients with prior chemotherapy (16.7%; p = 0.008). This effect did not reach significance for patients with prior radiation therapy/radiosurgery (66.7% vs. 33.3%, p = 0.238). The average interval between DAEs and the last documented lymphopenia was 32.25 weeks. Conclusions: This study describes the clinical and demographic features of patients with concurrent CNS tumors and MS and suggests several practical approaches to their clinical management. Our findings suggest that adding a disease-modifying MS therapy to the regimen of patients treated with chemotherapy is necessary only if the patient suffers from a highly active, aggressive course of MS. In view of the lack of prospective trials, individual risk assessments should remain the foundation of the decision on MS treatment in concurrent CNS tumor diseases.

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Author:Yavor Vasilev YalachkovORCiDGND, Dilara Dabanli, Katharina Wenger-AlakmehORCiDGND, Marie-Thérèse ForsterORCiDGND, Joachim Peter SteinbachORCiDGND, Martin VossORCiDGND
Parent Title (English):Neurological sciences
Place of publication:Milano
Document Type:Article
Date of Publication (online):2022/05/19
Date of first Publication:2022/05/19
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/12/05
Tag:CNS tumor; Clinical management; Concurrent CNS diseases; Multiple sclerosis
Page Number:10
First Page:5513
Last Page:5522
The data that support the findings of this study are available in anonymized form from the corresponding author upon reasonable request. The data are not publicly available due to privacy and ethical restrictions.
Open Access funding enabled and organized by Projekt DEAL
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International