原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的局限于中枢神经系统的结外淋巴瘤。小型单中心研究表明，PCNSL 患者可能存在静脉血栓栓塞 (VTE) 的高风险。本系统评价旨在评估 PCNSL 患者发生 VTE 的风险。使用系统审查和荟萃分析指南的首选报告项目进行了系统审查。检索了 1990 年至 2022 年的 MEDLINE、Embase 和 CINAHL。其中包括前瞻性和回顾性观察性研究以及临床试验。主要疗效结局是静脉血栓栓塞，主要安全性结局是个别研究定义的大出血。筛选 883 项研究后，纳入 46 项 PCNSL 研究（3688 名患者）。平均年龄为 62.4 岁。五项研究探讨了血栓预防（乙酰水杨酸或抗凝[n = 1]）和低分子量肝素（n = 4）的使用。总体而言，420 名患者发生了 VTE（11.4%），其中包括 17 起致命事件（占所有 VTE 的 4%）。两项涉及 77 名患者的 VTE 预防研究发现了 8 例突破性 VTE 事件 (10.4%)。大多数研究（n = 34；74.5%）没有报告严重出血并发症。在报告出血的研究中，2361 名患者中报告了 174 起大出血事件 (7.4%)，其中 3 起归因于血栓预防。 PCNSL 患者似乎面临 VTE 和出血并发症的高风险。未来针对这一人群的临床试验应定期收集有关 VTE 和出血发生率的数据，以帮助临床医生评估这一高危患者人群中血栓预防的风险与获益比。© 2024 作者。

Primary central nervous system lymphoma (PCNSL) is a rare extranodal lymphoma localized to the central nervous system. Small single-center studies have suggested that patients with PCNSL may be at high risk of venous thromboembolism (VTE). This systematic review aimed to estimate the risk of VTE in patients with PCNSL. A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, Embase, and CINAHL were searched from 1990 to 2022. Prospective and retrospective observational studies as well as clinical trials were included. The primary efficacy outcome was VTE, and the primary safety outcome was major bleeding as defined by the individual studies. After screening 883 studies, 46 studies (3688 patients) with PCNSL were included. Mean age was 62.4 years. Five studies explored the use of thromboprophylaxis (acetyl salicylic acid or anticoagulation [n = 1]) and low-molecular-weight heparin (n = 4). Overall, 420 patients developed VTE (11.4%), including 17 fatal events (4% of all VTE). Two studies that reported on VTE prophylaxis representing 77 patients identified 8 breakthrough VTE events (10.4%). Most studies (n = 34; 74.5%) did not report major bleeding complications. Among studies reporting on bleeding, 174 major bleeding (7.4%) events were reported out of 2361 patients, 3 of which were attributed to thromboprophylaxis. Patients with PCNSL seem to be at high risk of both VTE and bleeding complications. Future clinical trials in this population should routinely collect data on incidence of VTE and bleeding to help clinicians assess the risk-to-benefit ratio of thromboprophylaxis in this high-risk patient population.© 2024 The Authors.