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Prognosis after high-dose chemotherapy followed by autologous stem-cell transplantation as first-line treatment in primary CNS lymphoma—a long-term follow-up study

Kasenda, B. ; Schorb, E. ; Fritsch, K. ; Finke, J. ; Illerhaus, G.

In: Annals of Oncology, 2012, vol. 23, no. 10, p. 2670-2675

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    Titre
    • Prognosis after high-dose chemotherapy followed by autologous stem-cell transplantation as first-line treatment in primary CNS lymphoma—a long-term follow-up study
    Auteur
    • Kasenda, B.. Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
    • Schorb, E.. Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
    • Fritsch, K.. Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
    • Finke, J.. Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
    • Illerhaus, G.. Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Oncology, 2012, vol. 23, no. 10, p. 2670-2675. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:299955
    Summary
    Background High-dose chemotherapy followed by autologous stem-cell transplantation (HCT-ASCT) is a promising approach in eligible patients with primary central nervous system lymphoma (PCNSL). We report long-term data of patients who were treated according to HCT-ASCT containing protocols. Patients and methods We analyzed survival and relapse rates in 43 (<67 years) immunocompetent patients with newly diagnosed PCNSL being treated according to two different high-dose methotrexate-based protocols followed by high-dose carmustine/thiotepa (BCNU/TT) plus ASCT (±whole brain irradiation). Analysis was conducted for all patients (intention-to-treat) and those patients who actually received HCT-ASCT (per-protocol). Results Thirty-four patients achieved complete remission, of those 12 relapsed (35%), while 6 of them relapsed 5 years after diagnosis. After a median follow-up of 120 months, median overall survival (OS) was reached after 104 months. Two- and 5-year OS was 81% and 70% and 2- and 5-year event-free survival (EFS) was 81% and 67%, respectively. In per-protocol analysis (N=34), 5-year OS and EFS was 82% and 79%, respectively. HCT-ASCT associated related mortality was not observed. Conclusions Sequential high-dose MTX containing chemotherapy followed by high-dose carmustine/thiotepa plus ASCT (±whole brain irradiation) is safe and leads to high survival rates in eligible patients with newly diagnosed PCNSL