Article ; Online: Long-term Outcomes in Primary CNS Lymphoma After R-MVP and High-Dose Chemotherapy With Autologous Hematopoietic Stem Cell Transplant.
2023 Volume 101, Issue 7, Page(s) e710–e716
Abstract: Background and objectives: Primary CNS lymphoma (PCNSL), a rare CNS malignancy, is usually treated with high-dose methotrexate in the first-line setting, typically followed by consolidation therapy. Due to the broad range of currently available ... ...
| Abstract | Background and objectives: Primary CNS lymphoma (PCNSL), a rare CNS malignancy, is usually treated with high-dose methotrexate in the first-line setting, typically followed by consolidation therapy. Due to the broad range of currently available treatments for PCNSL, comparability in long-term follow-up studies is limited, and data are scattered across small studies. Methods: In this study, we report the long-term survival of patients with newly diagnosed immunocompetent PCNSL, enrolled in a phase II trial from June 2005 to September 2011. Patients were treated using rituximab, methotrexate, vincristine, and procarbazine (R-MVP) chemotherapy followed by high-dose chemotherapy (HDC) and autologous stem cell transplant (ASCT) in those with partial or complete response to R-MVP. In a post hoc analysis, clinical and imaging features were evaluated in those still alive. Results: 26 of 32 patients underwent HDC-ASCT consolidation. Of them, 3 patients died of treatment-related toxicity and 2 due to disease progression within 1 year of ASCT. None of the remaining 21 patients had disease progression with a median follow-up of 12.1 years and were included in the analysis. Compared with the post-HDC-ASCT assessment, at the last follow-up, there was no significant difference in the median Karnofsky Performance Status (80 [range: 60-100] vs 90 [range: 70-100]), the median Neurologic Assessment in Neuro-Oncology score (1 [range: 0-4] vs 1 [range: 0-5]), and leukoencephalopathy score (1 [range: 0-3] vs 1 [range: 1-4]). Discussion: Long-term follow-up demonstrated that treatment was well tolerated in most patients enrolled in this study, with stable leukoencephalopathy on imaging and stable clinical performance status. Disease recurrence was not observed beyond 2 years after HDC-ASCT consolidation. |
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| MeSH term(s) | Humans ; Antineoplastic Combined Chemotherapy Protocols ; Central Nervous System Neoplasms/therapy ; Central Nervous System Neoplasms/drug therapy ; Combined Modality Therapy ; Disease Progression ; Hematopoietic Stem Cell Transplantation/methods ; Leukoencephalopathies/drug therapy ; Lymphoma/drug therapy ; Methotrexate ; Neoplasm Recurrence, Local/drug therapy ; Rituximab/therapeutic use ; Transplantation, Autologous ; Vincristine/therapeutic use |
| Chemical Substances | Methotrexate (YL5FZ2Y5U1) ; Rituximab (4F4X42SYQ6) ; Vincristine (5J49Q6B70F) |
| Language | English |
| Publishing date | 2023-06-21 |
| Publishing country | United States |
| Document type | Clinical Trial, Phase II ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 207147-2 |
| ISSN | 1526-632X ; 0028-3878 |
| ISSN (online) | 1526-632X |
| ISSN | 0028-3878 |
| DOI | 10.1212/WNL.0000000000207490 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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