Treatment with methotrexate, rituximab, and cytosine arabinoside followed by autologous stem cell transplantation in primary central nervous system lymphoma: A single-center experience.

Autor:	Atilla PA; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey. Electronic address: pinar@ataca.tk., Atilla E; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Bozdag SC; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Yuksel MK; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Toprak SK; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Topcuoglu P; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Demirer T; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Ilhan O; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Arslan O; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Gurman G; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey., Ozcan M; Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey.
Jazyk:	angličtina
Zdroj:	Hematology/oncology and stem cell therapy [Hematol Oncol Stem Cell Ther] 2018 Mar; Vol. 11 (1), pp. 13-17. Date of Electronic Publication: 2017 Jun 15.
DOI:	10.1016/j.hemonc.2017.05.030
Abstrakt:	Objective/background: Primary central nervous system lymphoma (PCNSL) is associated with worst prognosis compared with other aggressive non-Hodgkin's lymphomas. However, recent trials have demonstrated that long-term progression-free survival can be achieved by immunochemotherapy. Our goal is to present our experience in aggressive PCNSL in this study. Methods: We retrospectively evaluated the clinical features and management of 13 PCNSL patients who were diagnosed and treated between 2006 and 2015. Results: Nine patients received rituximab (R) 375mg/m 2 /day on Day 1, methotrexate (MTX) 3.5g/m 2 /day and cytosine arabinoside (ARA-C) 4.4g/m 2 /day on Day 2, as well as ARA-C 4.4g/m 2 /day on Day 3 every 28days, and underwent autologous stem cell transplantation. Two patients received procarbazine instead of ARA-C. One patient relapsed, and allogeneic hematopoietic stem cell transplantation was performed. All nine patients are followed in complete remission. Two of 13 patients received one course of MTX and 36-45Gy radiotherapy and died. One patient with renal transplantation had progressive disease and died. Grade 3-4 hematological toxicity was detected in 11 (85%), Grade 3-4 mucositis in 11 (85%), and febrile neutropenia in 12 (92%) patients. The median overall survival in the R-MTX-ARA-C/procarbazine group was 28±16months. Conclusion: R-MTX-ARA-C followed by autologous stem cell transplantation seems a promising strategy with high response rates in PCNSL. (Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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