Combination of rituximab and methotrexate followed by rituximab and cytarabine in elderly patients with primary central nervous system lymphoma.

Autor: Yi JH; Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea., Kim SJ; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Yang DH; Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea., Do YR; Department of Medicine, Dongsan Medical Center, Daegu, Korea., Won JH; Department of Hematology-Oncology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea., Baek D; Department of Hematology-Oncology, Kyungpook National University Hospital, Kyungpook National University, Daegu, Korea., Shin HJ; Department of Internal Medicine, Pusan National University Hospital, Busan, Korea., Kim DS; Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea., Kim HJ; Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea., Kang KW; Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea., Bae SH; Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Korea., Kwon JH; Department of Internal Medicine, Chungbuk National University Hospital, Chungju, Korea., Kwon JH; Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea., Park BB; Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea., Kim WS; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Nov; Vol. 205 (5), pp. 1773-1781. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1111/bjh.19659
Abstrakt: The optimal treatment strategy for newly diagnosed primary central nervous system lymphoma (PCNSL) has yet to be established, especially in the elderly. In the current study, we conducted a phase II study to evaluate the efficacy and safety of rituximab plus high-dose MTX followed by rituximab plus cytarabine in patients aged ≥60 years newly diagnosed with PCNSL. Patients received an induction treatment of high-dose methotrexate plus rituximab followed by two cycles of a consolidation treatment of cytarabine plus rituximab. The primary end-point was a 2-year progression-free survival (PFS) rate. A total of 35 patients were recruited, and their median age was 73 (range: 60-81). After induction treatment, the complete and partial responses (PRs) were 56% and 20% respectively. Twenty-six patients proceeded to the consolidation treatment; the complete and PRs were 59% and 9% respectively. After a median follow-up duration of 36.0 months, the 2-year PFS rate was 58.7%. Treatment was generally well-tolerated as only three patients were withdrawn from the study due to toxicity, and no treatment-related mortality was reported. The 2-year overall survival rate was 77.9%. The current study may suggest the feasibility of administering high-dose MTX plus cytarabine in PCNSL patients aged ≥60 years and the potential role of additive rituximab.
(© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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