R-MPV followed by high-dose chemotherapy with thiotepa-based and autologous stem cell transplantation for newly diagnosed primary central nervous system lymphoma: a single-center experience
- Author:
Ji Yun LEE
1
;
Jin Ho PAIK
;
Koung Jin SUH
;
Ji-Won KIM
;
Se Hyun KIM
;
Jin Won KIM
;
Yu Jung KIM
;
Keun-Wook LEE
;
Jee Hyun KIM
;
Soo-Mee BANG
;
Jong-Seok LEE
;
Jeong-Ok LEE
Author Information
- Publication Type:ORIGINAL ARTICLE
- From:Blood Research 2021;56(4):285-292
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:High-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) as a consolidation treatment is a promising approach for eligible patients with newly diagnosed primary central nervous system lymphoma (PCNSL).
Methods:In this retrospective analysis, 22 patients with newly diagnosed PCNSL received chemotherapy with rituximab, methotrexate, procarbazine, and vincristine. Those who showed complete or partial response subsequently received consolidation HDC-ASCT with a thiotepa-based conditioning regimen but did not undergo radiotherapy.
Results:The PCNSL patients had a median age of 57 years (range, 49‒67 yr); of the total patients, 9.1% had a performance status of 2 or higher, and 72.1% had multiple lesions.Approximately 82% of patients received six cycles of induction chemotherapy, which was well tolerated with excellent disease control. The rate of confirmed or unconfirmed complete response increased from 45.5% at the period of interim analysis to 81.8% prior to the initiation of HDC-ASCT. With a median follow-up of 19.6 months (range, 7.5‒56.5 mo), the 2-year progression-free survival and overall survival estimates were 84% and 88%, respectively. No treatment-related deaths occurred. Grade 3 toxicity was recorded in 90.9% of the patients after undergoing the HDC-ASCT, and the most common grade 3 adverse event was febrile neutropenia without sepsis.
Conclusion:The discussed treatment approach is feasible in patients with newly diagnosed PCNSL, yielding encouraging results.
