Publication Only: Aggressive non-Hodgkin lymphoma - Clinical
High-dose MTX-containing chemotherapy and autologous stem sell transplantation (HDC-ASCT) is a potentially curable options for patients with primary central nervous system lymphoma (PCNCL). In our prospective study, pts with newly diagnosed PCNSL were treated with R-MPV (rituximab, methotrexate, vincristine and procarbazine) chemotherapy, followed by consolidation HDC-ASCT with TBC (thiotepa, busulfan and cyclophosphamide). After completion of therapy all pts reseived maintenance treatment with temozolomide every 3 months for a total of 2 years.
To assess the efficacy and safety of regimens R-MPV/TBC for patients with PCNSL.
A total 19 pts were enrolled in prospective study between 2015 to 2019 years. The median age was 43 years (range, 20 to 62 years), with a total of 2 (10%) ≥ 60 years of age. Male:female = 13:7. In four pts (21%) the ECOG status was ≥ 2. The MSKCC prognostic class was as follows: 17 pts (91%), class 1; 2 pts (9%), class 2; 0 pts, class 3.
Following 3-5 R-MPV cycles 16 pts were in CR and 3 pts in PR. All pts were undegro stem-sell harvest after the second cycle. All pts eventually received HDC-ASCT with TBC. Treatment-related mortality was 0%. All pts achieved haemotopoietic regeneration: the median times neutrophil and platelet recovery were 9 and 14 days, respectively. Seventeen pts are alive and well in complete remission at a median follow-up of 12 months (range 1-40). Two pts with progressive disease (+6 months) went on to received second-line treatment: both had received chemotherapy and WBRT.
Regimens R-MPV/TBC was associated with favorable safety and high preliminary efficacy.