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High-dose chemotherapy with autologous haematopoietic stem cell support for relapsed or refractory primary CNS lymphoma: a prospective multicentre trial by the German Cooperative PCNSL study group

To investigate safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation (HCT-ASCT) in relapsed/refractory (r/r) primary central nervous system lymphoma (PCNSL), we conducted a single-arm multicentre study for immunocompetent patients (<66 years) with PCNSL fa...

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Hauptverfasser: Kasenda, Benjamin (VerfasserIn) , Egerer, Gerlinde (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2017
In: Leukemia
Year: 2017, Jahrgang: 31, Heft: 12, Pages: 2623-2629
ISSN:1476-5551
DOI:10.1038/leu.2017.170
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1038/leu.2017.170
Verlag, Volltext: https://www.nature.com/articles/leu2017170
Volltext
Verfasserangaben:B. Kasenda, G. Ihorst, R. Schroers, A. Korfel, I. Schmidt-Wolf, G. Egerer, L. von Baumgarten, A. Röth, J. Bloehdorn, R. Möhle, M. Binder, U. Keller, M. Lamprecht, M. Pfreundschuh, E. Valk, H. Fricker, E. Schorb, K. Fritsch, J. Finke and G. Illerhaus
Beschreibung
Zusammenfassung:To investigate safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation (HCT-ASCT) in relapsed/refractory (r/r) primary central nervous system lymphoma (PCNSL), we conducted a single-arm multicentre study for immunocompetent patients (<66 years) with PCNSL failing high-dose methotrexate)-based chemotherapy. Induction consisted of two courses of rituximab (375 mg/m2), high-dose cytarabine (2 × 3 g/m2) and thiotepa (40 mg/m2) with collection of stem cells in between. Conditioning for HCT-ASCT consisted of rituximab 375 mg/m2, carmustine 400 mg/m2 and thiotepa (4 × 5 mg/kg). Patients commenced HCT-ASCT irrespective of response after induction. Patients not achieving complete remission (CR) after HCT-ASCT received whole-brain radiotherapy. Primary end point was CR after HCT-ASCT. We enrolled 39 patients; median age and Karnofsky performance score are 57 years and 90%, respectively. About 28 patients had relapsed and 8 refractory disease. About 22 patients responded to induction and 32 patients commenced HCT-ASCT. About 22 patients (56.4%) achieved CR after HCT-ASCT. Respective 2-year progression-free survival (PFS) and overall survival (OS) rates were 46.0% (median PFS 12.4 months) and 56.4%; median OS not reached. We recorded four treatment-related deaths. Thiotepa-based HCT-ASCT is an effective treatment option in eligible patients with r/r PCNSL. Comparative studies are needed to further scrutinise the role of HCT-ASCT in the salvage setting.
Beschreibung:Advance online publication, 16 June 2017
Gesehen am 28.06.2018
Beschreibung:Online Resource
ISSN:1476-5551
DOI:10.1038/leu.2017.170

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