Three Cases Treated with High-dose Cytarabine and Etoposide followed by Autologous Stem Cell Transplantation for Relapsed Primary CNS Lymphoma.
10.5045/kjh.2005.40.3.172
- Author:
Ja Eun KOO
1
;
Min Hee RYU
;
Hee Jeong SHON
;
Hye Jin KANG
;
Woo Kun KIM
;
Cheolwon SUH
;
Jung Shin LEE
;
Yoon Koo KANG
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ykkang@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Autoimmune hemolytic anemia;
Waldenstrom macroglobulinemia;
Fludarabine
- MeSH:
Anemia, Hemolytic, Autoimmune;
Carmustine;
Cyclophosphamide;
Cytarabine*;
Disease Progression;
Disease-Free Survival;
Drug Therapy;
Etoposide*;
Febrile Neutropenia;
Humans;
Lymphoma*;
Radiotherapy;
Recurrence;
Stem Cell Transplantation*;
Stem Cells*;
Thrombocytopenia;
Waldenstrom Macroglobulinemia
- From:Korean Journal of Hematology
2005;40(3):172-176
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The treatment outcomes with conventional second-line chemotherapy or radiotherapy aregenerally very poor for patients with relapsed primary CNS lymphoma (PCNSL). We treated three relapsed PCNSL patients with high-dose cytarabine plus etoposide (CYVE) chemotherapy, and this was followed by autologous stem cell transplantation (ASCT). The salvage CYVE chemotherapy consisted of cytarabine 2g/m2/d on days 2 to 5 in a 3-hour infusion and 50mg/m2/d on days 1 to 5 in a 12-hourinfusion, and etoposide 200mg/m2/d on days 2 to 5 in a 2-hour infusion. After two cycles of CYVE chemotherapy, two patients achieved a complete response (CR), and one patient achieved a partial response (PR). All three patients experienced febrile neutropenia and grade 4 thrombocytopenia with the CYVE chemotherapy. However, the hematologic toxicities were well managed without any complications. The conditioning regimen for ASCT consisted of BCNU 300mg/m2 on day -7, etoposide 100mg/m2 on days -6 to -3, cytarabine 100mg/m2 on days -6 to -3, and cyclophosphamide 35mg/kg on days -6 to -3 (BEAC). After ASCT, the patient who initially showed a PR with CYVE chemotherapy then achieved a CR. At the time of this report, one patient remained alive in CR for 41 months after CYVE chemotherapy. The remaining two patients experienced relapse 5 months and 4 months after ASCT, respectively, and they ultimately died of disease progression 18 months and 8 months after ASCT, respectively. In our cases, the CYVE chemotherapy+ASCT was well tolerated, and this induced the complete disappearance of the tumor, and one patient showed prolonged disease-free survival. CYVE chemotherapy+ASCT could be a treatment option for relapsed PCNSL.
