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Intensive chemotherapy followed by hematopoietic stem-cell rescue for refractory and recurrent primary CNS and intraocular lymphoma: Société Française de Greffe de Moëlle Osseuse-Thérapie Cellulaire.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2008 May 20; Vol. 26 (15), pp. 2512-8. Date of Electronic Publication: 2008 Apr 14. - Publication Year :
- 2008
-
Abstract
- Purpose: The prognosis of relapsing primary CNS lymphoma (PCNSL) is poor. We report the results of a prospective multicenter trial of intensive chemotherapy followed by autologous hematopoietic stem-cell rescue (IC + HCR) in immunocompetent adult patients with PCNSL or intraocular lymphoma (IOL) after failure of high-dose methotrexate-based treatment.<br />Patients and Methods: Salvage treatment consisted of two cycles of high-dose cytarabine and etoposide (CYVE). Intensive chemotherapy combined thiotepa, busulfan, and cyclophosphamide. Forty-three patients (median age, 52 years; range, 23 to 65 years) were included, with relapse (n = 22), refractory disease (n = 17), or a partial response to first-line treatment (n = 4). The response to CYVE was not assessable in three cases because of treatment-related death. Twenty patients (47%) were chemosensitive to CYVE: 15 of them proceeded to IC + HCR. IC + HCR was also administered to 12 patients who did not respond to CYVE. All but one of the 27 patients who underwent IC + HCR entered complete remission.<br />Results: With a median follow-up of 36 months, the median overall survival was 18.3 months in the overall population, and 58.6 months among patients who completed IC + HCR. The respective median progression-free survival (PFS) times after IC + HCR were 11.6 and 41.1 months. The 2-year overall survival probability was 45% in the whole population and 69% among the 27 patients who received IC + HCR. The 2-year PFS probability was 43% among all the patients and 58% in the IC + HCR subpopulation.<br />Conclusion: IC + HCR is an effective treatment for refractory and recurrent PCNSL.
- Subjects :
- Adult
Aged
Brain Neoplasms drug therapy
Busulfan administration & dosage
Combined Modality Therapy
Cyclophosphamide administration & dosage
Cytarabine administration & dosage
Etoposide administration & dosage
Eye Neoplasms drug therapy
Female
Humans
Lymphoma, Large B-Cell, Diffuse drug therapy
Male
Middle Aged
Neoplasm Recurrence, Local drug therapy
Prospective Studies
Survival Rate
Thiotepa administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Brain Neoplasms therapy
Eye Neoplasms therapy
Hematopoietic Stem Cell Transplantation
Lymphoma, Large B-Cell, Diffuse therapy
Neoplasm Recurrence, Local therapy
Salvage Therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1527-7755
- Volume :
- 26
- Issue :
- 15
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 18413641
- Full Text :
- https://doi.org/10.1200/JCO.2007.13.5533