Intensive chemotherapy followed by autologous stem cell transplantation in primary central nervous system lymphomas (PCNSLs). Therapeutic outcomes in real life-experience of the French Network.
Autor: | Schenone L; Université de Lorraine, Department of Hematology, CHRU de Nancy, Hôpital de Brabois, Nancy, France., Houillier C; Department of Neurology, APHP, Sorbonne Université, IHU, ICM, Groupe Hospitalier Pitié-Salpêtrière, Paris, France., Tanguy ML; Department of Biostatistics, Institut Gustave Roussy, Villejuif, Paris, France., Choquet S; Department of Hematology, APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France., Agbetiafa K; Department of Hematology, Institut Curie, Site Saint-Cloud, France., Ghesquières H; Department of Hematology, Centre Hospitalier Lyon Sud, Lyon, France., Damaj G; Department of Hematology, CHU de Caen Normandie, Caen, France., Schmitt A; Department of Hematology, Institut Bergonié, Bordeaux, France., Bouabdallah K; Department of hematology and cell therapy, University Hospital of Bordeaux, F-33000, Bordeaux, France., Ahle G; Department of Neurology Pôle NNORR, Hôpitaux Civils de Colmar, Colmar, France., Gressin R; Department of Hematology, CHU de Grenoble, Grenoble, France., Cornillon J; Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France., Houot R; Department of Hematology, CHU Rennes, Rennes, France., Marolleau JP; Department of Hematology, CHU Amiens, Amiens, France., Fornecker LM; Department of Hematology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France., Chinot O; Department of Neuro-oncology, AP-HM, CHU Timone, Marseille, France., Peyrade F; Department of Hematology, Centre Antoine Lacassagne, Nice, France., Bouabdallah R; Hôpital Privé de Provence, Pôle de cancérologie, Aix-en-Provence, France., Moluçon-Chabrot C; Department of Hematology, CHU Clermont-Ferrand, Clermont-Ferrand, France., Gyan E; Department of Hematology and Cellular Therapy, CHU de Tours, Tours, France., Chauchet A; Department of Hematology, CHRU de Besançon, Besançon, France., Casasnovas O; Department of Hematology, CHU Dijon Bourgogne, Dijon, France., Oberic L; Department of Hematology, Institut Universitaire du Cancer de Toulouse, Toulouse, France., Delwail V; Department of Hematology and cellular Therapy, CHU de Poitiers, Poitiers, France., Abraham J; Department of Hematology, CHU Dupuytren Limoges, Limoges, France., Roland V; Department of Hematology, CH Saint Jean, Perpignan, France., Waultier-Rascalou A; Department of Hematology, CHU Nimes Caremeau, Nimes, France., Willems L; Department of Hematology, CHU Paris Centre Site Cochin, Paris, France., Morschhauser F; Institute of Hematology-transfusion, CHRU de Lille, Lille, France., Fabbro M; Department of Oncology, Institut regional cancer Montpellier, Montpellier, France., Ursu R; Department of Neurology, AP-HP, Hôpital Saint-Louis, Paris, France., Thieblemont C; Department of Hematology, AP-HP, Hôpital Saint-Louis, Paris, France., Jardin F; Department of Hematology, Centre Henri Becquerel, Rouen, France., Tempescul A; Department of Hematology, CHRU de Brest, Brest, France., Malaise D; Department of Ophthalmology, Institut Curie, Paris, France.; Institut Curie, PSL University, Inserm U1288, Laboratoire d'Imagerie Translationnelle en Oncologie, Orsay, France., Touitou V; Department of Ophthalmology, APHP, Hôpital Pitié-Salpêtrière, Paris, France., Nichelli L; Department of Neuro-radiology, APHP, Hôpital Pitié-Salpêtrière, Paris, France., Le Garff-Tavernier M; Department of biological Hematology, APHP, Hôpital Pitié-Salpêtrière, Paris, France., Plessier A; Department of Hepato gastroenterology, APHP, Hôpital Beaujon, Paris, France., Bourget P; Department of functional explorations, APHP, Hôpital Necker, Paris, France., Bonmati C; Department of Hematology, CHRU de Nancy, Hôpital de Brabois, Nancy, France., Wantz-Mézières S; Université de Lorraine, CNRS, Inria, IECL, F-54000, Nancy, France., Giordan Q; Pharmacy department, CHR Metz-Thionville, Hôpital de Mercy, Metz, France., Dorvaux V; Department of Hematology, CHR Metz-Thionville, Hôpital de Mercy, Metz, France., Charron C; Intensive care department, University Hospital Ambroise Paré, AP-HP, Boulogne-Billancourt, France., Jabeur W; Department of Neurology, Hôpital Foch, Suresnes, France., Hoang-Xuan K; Department of Neurology, APHP, Sorbonne Université, IHU, ICM, Groupe Hospitalier Pitié-Salpêtrière, Paris, France., Taillandier L; Department of Neurology, CHRU de Nancy, Hôpital Central, Nancy, France., Soussain C; Department of Hematology, Institut Curie, Site Saint-Cloud, France. carole.soussain@curie.fr.; INSERM U932 Institut Curie, PSL Research University, Paris, France. carole.soussain@curie.fr. |
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Jazyk: | angličtina |
Zdroj: | Bone marrow transplantation [Bone Marrow Transplant] 2022 Jun; Vol. 57 (6), pp. 966-974. Date of Electronic Publication: 2022 Apr 14. |
DOI: | 10.1038/s41409-022-01648-z |
Abstrakt: | We analysed the therapeutic outcomes of all consecutive patients with primary central nervous system lymphoma (PCNSL) registered in the prospective French database for PCNSL and treated with intensive chemotherapy (IC) followed by autologous stem cell transplantation (IC-ASCT) between 2011 and November 2019 (271 patients recruited, 266 analysed). In addition, treatment-related complications of thiotepa-based IC-ASCT were analysed from the source files of 85 patients from 3 centers. Patients had received IC-ASCT either in first-line treatment (n = 147) or at relapse (n = 119). The median age at IC-ASCT was 57 years (range: 22-74). IC consisted of thiotepa-BCNU (n = 64), thiotepa-busulfan (n = 24), BCNU-etoposide-cytarabine-melphalan (BEAM, n = 36) and thiotepa-busulfan-cyclophosphamide (n = 142). In multivariate analysis, BEAM and ASCT beyond the first relapse were adverse prognostic factors for relapse risk. The risk of treatment-related mortality was higher for ASCT performed beyond the first relapse and seemed higher for thiotepa-busulfan-cyclophosphamide. Thiotepa-BCNU tends to result in a higher relapse rate than thiotepa-busulfan-cyclophosphamide and thiotepa-busulfan. This study confirms the role of IC-ASCT in first-line treatment and at first-relapse PCNSL (5-year overall survival rates of 80 and 50%, respectively). The benefit/risk ratio of thiotepa-busulfan/thiotepa-busulfan-cyclophosphamide-ASCT could be improved by considering ASCT earlier in the course of the disease and dose adjustment of the IC. (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.) |
Databáze: | MEDLINE |
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