{
  "abstract": "Background: Clinical scores incompletely capture outcomes in primary central nervous system lymphoma (PCNSL). We quantified morphologic heterogeneity in pretreatment hematoxylin and eosin (H\\&E) whole slides. Patients and methods: Three independent cohorts of immunocompetent, HIV- and EBV-negative patients treated recently were analyzed: LOC 2023 (122 slides), phase III BLOCAGE-01 (245 slides; NCT02313389), and external Barcelona (BCN; 41 slides). UNI embeddings, prototype learning, spatial metrics, and elastic-net Cox regression defined ITH-C. Results: Models achieved bootstrap-corrected concordance of 0.797--0.834. Age-, sex-, and KPS-adjusted ITH-C HRs were 1.29 (95\\% CI 1.01--1.64), 1.27 (1.07--1.51), and 2.13 (1.35--3.37), respectively. Adding ITH-C increased MSKCC C-index from 0.671 to 0.717, 0.560 to 0.593, and 0.588 to 0.706. Spatial transcriptomics linked ITH-C to immune programs. Conclusions: Routine H\\&E encodes prognostic spatial heterogeneity in PCNSL. ITH-C complements clinical scores, supporting prospective risk stratification.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "New results",
  "arxiv": null,
  "author_total": 42,
  "authors": [
    {
      "name": "L. Rincon de la Rosa"
    },
    {
      "name": "N. Barillot"
    },
    {
      "name": "I. Hernandez-Verdin"
    },
    {
      "name": "R. Velasco"
    },
    {
      "name": "B. Mathon"
    },
    {
      "name": "S. Eimer"
    },
    {
      "name": "J. R. Vignes"
    },
    {
      "name": "A. Rousseau"
    },
    {
      "name": "J. Paillassa"
    },
    {
      "name": "G. Ahle"
    },
    {
      "name": "F. Lerintiu"
    },
    {
      "name": "E. Uro-Coste"
    },
    {
      "name": "L. Oberic"
    },
    {
      "name": "E. Tabouret"
    },
    {
      "name": "R. Appay"
    },
    {
      "name": "G. Gauchotte"
    },
    {
      "name": "L. Taillandier"
    },
    {
      "name": "J.-P. Marolleau"
    },
    {
      "name": "C. Adam"
    },
    {
      "name": "R. Ursu"
    },
    {
      "name": "S. Cuzzubbo"
    },
    {
      "name": "A. Schmitt"
    },
    {
      "name": "L. Nichelli"
    },
    {
      "name": "A. Pons-Escoda"
    },
    {
      "name": "F. Charlotte"
    },
    {
      "name": "F. Davi"
    },
    {
      "name": "M. Le Garff-Tavernier"
    },
    {
      "name": "S. Choquet"
    },
    {
      "name": "C. Soussain"
    },
    {
      "name": "N. Vidal"
    },
    {
      "name": "E. Gonzalez-Barca"
    },
    {
      "name": "F. Climent"
    },
    {
      "name": "P. Lopez"
    },
    {
      "name": "F. Drieux"
    },
    {
      "name": "E.-L. Veresezan"
    },
    {
      "name": "M. Heming"
    },
    {
      "name": "G. Meyer zu Hörste"
    },
    {
      "name": "O. Grauer"
    },
    {
      "name": "F. Jardin"
    },
    {
      "name": "K. Mokhtari"
    },
    {
      "name": "C. Houillier"
    },
    {
      "name": "Hoang-Xua"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4ft26qfs06g5c.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.31.748241",
  "fulltext_url": "https://www.biorxiv.org/content/10.64898/2026.08.31.748241v1.full",
  "id": "4ft26qfs06g5c",
  "issns": [],
  "landing_url": "https://www.biorxiv.org/content/10.64898/2026.08.31.748241v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "biorxiv",
      "bioinformatics"
    ],
    [
      "openalex",
      "2728|CNS Lymphoma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7207614523",
  "pdf_url": "https://www.biorxiv.org/content/10.64898/2026.08.31.748241v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4ft26qfs06g5c.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:56Z",
      "native_id": "10.64898/2026.08.31.748241",
      "source": "biorxiv",
      "url": "https://www.biorxiv.org/content/10.64898/2026.08.31.748241v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "biorxiv:bioinformatics",
      "subfield": "bioinformatics"
    }
  ],
  "title": "Morphologic intratumoral heterogeneity from routine whole-slide histopathology is prognostic for survival in primary central nervous system lymphoma: development in the LOC Network and international external validation",
  "title_text": "Morphologic intratumoral heterogeneity from routine whole-slide histopathology is prognostic for survival in primary central nervous system lymphoma: development in the LOC Network and international external validation",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:56Z",
  "url": "https://research.draconitic.com/paper/4ft26qfs06g5c",
  "venue": "bioRxiv",
  "versions": []
}