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KMID : 1142020210560040285
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Blood Research
2021 Volume.56 No. 4 p.285 ~ p.292
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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
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Lee Ji-Yun
Paik Jin-Ho
Suh Koung-Jin
Kim Ji-Won
Kim Se-Hyun
Kim Jin-Won
Kim Yu-Jung
Lee Keun-Wook
Kim Jee-Hyun
Bang Soo-Mee
Lee Jong-Seok
Lee Jeong-Ok
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Abstract
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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.
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KEYWORD
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Primary CNS lymphoma, Autologous stem-cell transplantation, Consolidation, Thiotepa
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