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

噻替帕 医学 布苏尔班 自体干细胞移植 原发性中枢神经系统淋巴瘤 移植 外科 内科学 肿瘤科 环磷酰胺 化疗 卡莫司汀
作者
Laurence Schenone,Caroline Houillier,Marie Laure Tanguy,Sylvain Choquet,Kossi Agbétiafa,Hervé Ghesquières,Gandhi Damaj,Anna Schmitt,Krimo Bouabdallah,Guido Ahle,Rémy Gressin,Jérôme Cornillon,Roch Houot,Jean‐Pierre Marolleau,Luc‐Matthieu Fornecker,Olivier Chinot,Frédéric Peyrade,Réda Bouabdallah,Cécile Moluçon‐Chabrot,Emmanuel Gyan,Adrien Chauchet,Olivier Casasnovas,Lucie Obéric,Vincent Delwail,Julie Abraham,Virginie Roland,Agathe Waultier‐Rascalou,Lise Willems,Franck Morschhauser,Michel Fabbro,Rénata Ursu,Catherine Thiéblemont,Fabrice Jardin,Adrian Tempescul,Denis Malaise,Valérie Touitou,Lucia Nichelli,Magali Le Garff‐Tavernier,Aurélie Plessier,Philippe Bourget,Caroline Bonmati,Sophie Wantz-Mézières,Quentin Giordan,Véronique Dorvaux,Cyril Charron,Waliyde Jabeur,Khê Hoang‐Xuan,Luc Taillandier,Carole Soussain,Caroline Houillier,Sylvain Choquet,Khê Hoang‐Xuan,Valérie Touitou,Carole Soussain,Nathalie Cassoux,Denis Malaise,Renata Ursu,Lise Willems,Hervé Ghesquières,Anna Schmitt,Olivier Chinot,Émeline Tabouret,Luc Taillandier,Marie Blonski,Roch Houot,Guido Ahle,Gandhi Damaj,Cécile Moluçon‐Chabrot,Vincent Delwail,Michel Fabbro,Fabrice Jardin,Adrien Chauchet,Franck Morschhauser,Olivier Casasnovas,Rémy Gressin,Luc‐Matthieu Fornecker,Julie Abraham,Jean‐Pierre Marolleau,Adrian Tempescul,Philippe Agapé,Lucie Obéric,Emmanuel Gyan,Frédéric Peyrade,Thomas Gastinne
出处
期刊:Bone Marrow Transplantation [Springer Nature]
卷期号:57 (6): 966-974 被引量:18
标识
DOI:10.1038/s41409-022-01648-z
摘要

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.
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