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.

Antineoplastic Combined Chemotherapy Protocols / therapeutic use Busulfan Carmustine / therapeutic use Central Nervous System / pathology Central Nervous System Neoplasms / drug therapy Cyclophosphamide / therapeutic use Etoposide Hematopoietic Stem Cell Transplantation / adverse effects Humans Lymphoma / drug therapy Neoplasm Recurrence, Local / drug therapy Prospective Studies Thiotepa Transplantation, Autologous Treatment Outcome

Journal

Bone marrow transplantation

ISSN: 1476-5365

Titre abrégé: Bone Marrow Transplant

Pays: England

ID NLM: 8702459

Informations de publication

Date de publication:
06 2022

Historique:

received: 29 10 2021

accepted: 15 03 2022

revised: 05 03 2022

pubmed: 16 4 2022

medline: 18 6 2022

entrez: 15 4 2022

Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1038/s41409-022-01648-z PMID: 35422077

pubmed: 35422077

doi: 10.1038/s41409-022-01648-z

pii: 10.1038/s41409-022-01648-z

doi:

Substances chimiques

Etoposide 6PLQ3CP4P3

Cyclophosphamide 8N3DW7272P

Thiotepa 905Z5W3GKH

Busulfan G1LN9045DK

Carmustine U68WG3173Y

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

966-974

Investigateurs

Caroline Houillier (C)

Sylvain Choquet (S)

Khê Hoang-Xuan (K)

Valérie Touitou (V)

Carole Soussain (C)

Nathalie Cassoux (N)

Denis Malaise (D)

Renata Ursu (R)

Lise Willems (L)

Hervé Ghesquières (H)

Anna Schmitt (A)

Olivier Chinot (O)

Emeline Tabouret (E)

Luc Taillandier (L)

Marie Blonski (M)

Roch Houot (R)

Guido Ahle (G)

Gandhi Damaj (G)

Cécile Moluçon-Chabrot (C)

Vincent Delwail (V)

Michel Fabbro (M)

Fabrice Jardin (F)

Adrien Chauchet (A)

Franck Morschhauser (F)

Olivier Casasnovas (O)

Rémy Gressin (R)

Luc-Matthieu Fornecker (LM)

Julie Abraham (J)

Jean-Pierre Marolleau (JP)

Adrian Tempescul (A)

Philippe Agapé (P)

Lucie Oberic (L)

Emmanuel Gyan (E)

Frédéric Peyrade (F)

Thomas Gastinne (T)

Informations de copyright

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