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
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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. / Kasenda, B; Ihorst, G; Schroers, R; Korfel, A; Schmidt-Wolf, I; Egerer, G; von Baumgarten, L; Röth, A; Bloehdorn, J; Möhle, R; Binder, M; Keller, U; Lamprecht, M; Pfreundschuh, M; Valk, E; Fricker, H; Schorb, E; Fritsch, K; Finke, J; Illerhaus, G.
In: LEUKEMIA, Vol. 31, No. 12, 12.2017, p. 2623-2629.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - 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
AU - Kasenda, B
AU - Ihorst, G
AU - Schroers, R
AU - Korfel, A
AU - Schmidt-Wolf, I
AU - Egerer, G
AU - von Baumgarten, L
AU - Röth, A
AU - Bloehdorn, J
AU - Möhle, R
AU - Binder, M
AU - Keller, U
AU - Lamprecht, M
AU - Pfreundschuh, M
AU - Valk, E
AU - Fricker, H
AU - Schorb, E
AU - Fritsch, K
AU - Finke, J
AU - Illerhaus, G
PY - 2017/12
Y1 - 2017/12
N2 - 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/m2and 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.
AB - 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/m2and 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.
KW - Adult
KW - Aged
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Brain
KW - Central Nervous System Neoplasms
KW - Combined Modality Therapy
KW - Drug Resistance, Neoplasm
KW - Female
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Lymphoma
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Recurrence
KW - Retreatment
KW - Transplantation, Autologous
KW - Treatment Outcome
KW - Clinical Trial, Phase II
KW - Journal Article
KW - Multicenter Study
U2 - 10.1038/leu.2017.170
DO - 10.1038/leu.2017.170
M3 - SCORING: Journal article
C2 - 28559537
VL - 31
SP - 2623
EP - 2629
JO - LEUKEMIA
JF - LEUKEMIA
SN - 0887-6924
IS - 12
ER -