Abstract Details

Title The Concomitant Incidence of Multiple Sclerosis and Primary CNS Tumors Leading to Treatment Dilemma.

Topic Neuro-oncology

Presentation(s) P16 - Poster Session 16 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-005

Objective To assess the correlation and incidence of Multiple Sclerosis (MS) and primary central nervous system (CNS) tumors in our cohort and whether any specific disease-modifying treatments (DMTs) were associated with increased incidence of primary CNS malignancy.

Background Primary CNS malignancies are driven by the immunosuppressed environment in the CNS. In contrast, MS is mainly caused by the complex interaction of humoral and adaptive immunity in the CNS, triggered by many different factors.

Design/Methods A retrospective data query was performed from our electronic medical record (EMR) between 2015-2021. Patients were identified using specific ICD-10 codes for MS and primary CNS malignancy. Metastatic brain tumors were excluded from the study.

Results 50 unique MS patients with primary CNS malignancy were identified from the initial results, out of which 11 patients were excluded as they did not meet the MS criteria or had metastatic lesions. In our cohort, 28 (71%) patients were female, with an average age of 62.2 years

Conclusions The incidence of Primary CNS malignancy in MS patients seems to be lower than the general population due to several different factors. It also provides a challenging treatment dilemma to balance the immune system. If the balance tips towards one side, it can cause neoplastic proliferation, while on the other spectrum can lead to extensive demyelination. Female MS patients were more likely to have both neurological conditions. The average age was 62.2 years, speculating that some of these patients still had ongoing MS disease activity. We found 85% of patients had benign CNS tumors, including meningiomas, while 15% of the MS patients had malignant primary brain tumors. Platform DMTs were most associated with CNS tumors. At the same time, the incidence decreased with higher efficacy DMTs. However, further extensive studies need to be done considering genetic and other factors associated with both conditions.

Authors/Disclosures
Sandeep Gill, MD (Aurathirty2) PRESENTER	Dr. Gill has nothing to disclose.
Muhammad Taimur A. Malik, MD (St Lukes)	Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genetech . Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jansen . Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD serono. The institution of Dr. Malik has received research support from National MS Society .

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