cns lymphoma | CNS primary lymphoma: CTHD-GACS provides high-level remission in newly diagnosed patients

CNS primary lymphoma: CTHD-GACS provides high-level remission in newly diagnosed patients




To remember

High-dose chemotherapy (Thiotepa and carmustine) with autologous stem cell graft (CTHD-GACS) resulted in a complete response in almost 8 of 10 patients who were diagnosed with a new diagnosis of primary nervous system lymphoma Central Office (CNS).
In most patients, the regimen did not have whole brain radiation (FCR).
Design of the study

Phase II study to examine the use of CTHD-GACS in 81 patients who received a new diagnosis of CNS primary lymphoma.
The analysis population included 79 patients.
Patients were recruited regardless of their clinical performance status.
Funding: study funded by the University Hospital of Fribourg and Amgen.
Main results

Full response (RC) and partial response rates were 77.2% and 13.9%, respectively, at 30 days after GACS.
Disease progression-free survival (SSP) at 12 months, 36 months and 60 months: 78.5%, 67% and 64.8%, respectively.
Overall survival (SG) at 12 months, 36 months and 60 months: 92%, 81% and 79%, respectively.
The progression of the disease affected 35% of patients during the median follow-up to 57.4 months; The cumulative incidence of death from relapse was 12% to 60 months.
A FCR after GACS was required in 14% of patients.
Adverse events (EI) of the most frequent grades 3 and 4 during induction: anemia (47%) and thrombocytopenia (63%), respectively.
EI of the most frequent grades 3 and 4 during CTHD-GACS: Fever (68%) and Leukopenia (93%), respectively.
Limits

Single-arm study.
Data on the effect of rescue treatments on survival outside the scope of the study were not collected.
Why is it important?

The recommended treatment for newly diagnosed primary CNS lymphoma consists of a high dose of methotrexate and a high dose of cytarabine, followed by radiation from the entire brain.
Most patients treated in this way relapse, and FCR has been associated with neurotoxicity.