The Efficacy and Safety of Modified Thiotepa-Based Conditioning Followed by Autologous Stem Cell Transplantation in Primary CNS Lymphomas.
10.19746/j.cnki.issn.1009-2137.2025.05.030
- Author:
Yan LI
1
;
Ping YANG
1
;
Fang BAO
1
;
Sen LI
1
;
Lan MA
1
;
Fei DONG
1
;
Ji-Jun WANG
1
;
Hong-Mei JING
1
Author Information
1. Department of Hematology, Peking University Third Hospital, Beijing 100191, China.
- Publication Type:Journal Article
- Keywords:
primary central nervous system lymphoma;
modified thiotepabased conditioning;
high dose chemotherapy;
autologous stem cell transplantation;
maintenance therapy
- MeSH:
Humans;
Thiotepa/therapeutic use*;
Retrospective Studies;
Transplantation, Autologous;
Transplantation Conditioning/methods*;
Central Nervous System Neoplasms/therapy*;
Hematopoietic Stem Cell Transplantation;
Female;
Male;
Middle Aged;
Adult;
Lymphoma/therapy*;
Treatment Outcome;
Aged
- From:
Journal of Experimental Hematology
2025;33(5):1435-1442
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore and evaluate the efficacy and safety of a modified thiotepa-based conditioning regimen combined with autologous hematopoietic stem cell transplantation (ASCT) for the treatment of primary central nervous system lymphoma (PCNSL).
METHODS:In a retrospective, single center, single arm study, we collected data of 28 patients with PCNSL who underwent high-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) at our center from March 2021 to December 2024. The clinical characteristics of the patients, the conditioning regimen details, treatment-related toxicities and adverse reactions, post-transplant disease remission status, and survival outcomes were analyzed.
RESULTS:A total of 28 patients were included. Among them, 19 patients received ASCT as first-line consolidation therapy in complete response (CR) or partial response (PR) status, and 9 patients with relapsed/refractory disease underwent salvage ASCT. The median time to neutrophil engraftment was 9 days (range: 5-11 days), and the median time to platelet engraftment was 10 days (range: 6-13 days). All patients achieved CR at the initial efficacy evaluation post-ASCT. The main complications during the transplantation period were febrile neutropenia (26 cases) and grade 3 diarrhea (9 cases). No transplantation-related mortality occurred. Post-ASCT, 19 patients received maintenance therapy, which was demonstrated to be safe and effective. Three patients relapse, and one patient died. The median progression-free survival (PFS) and overall survival (OS) of patients were not reached. The estimated 1-year and 2-year cumulative PFS rates were 88.4% and 66.3%, respectively, while the 1-year and 2-year OS rates were both 94.1%.
CONCLUSION:The modified thiotepa-based conditioning regimen combined with ASCT is safe and effective for the treatment of PCNSL.
