Blood Res.  2021 Dec;56(4):285-292. 10.5045/br.2021.2021073.

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

• Lee JY
• Paik JH
• Suh KJ
• Kim JW
• Kim SH
• Kim JW
• Kim YJ
• Lee KW
• Kim JH
• Bang SM
• Lee JS
• Lee JO

• KMID: 2524088
• DOI: http://doi.org/10.5045/br.2021.2021073

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.

Keyword

Primary CNS lymphoma; Autologous stem-cell transplantation; Consolidation; Thiotepa

Figure

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  Fig. 1 Kaplan-Meier curves for OS and PFS.

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