R-MPV followed by high-dose chemotherapy with thiotepa-based and autologous stem cell transplantation for newly diagnosed primary central nervous system lymphoma: a single-center experience
Ji Yun Lee1, Jin Ho Paik2, Koung Jin Suh1, Ji-Won Kim1, Se Hyun Kim1, Jin Won Kim1, Yu Jung Kim1, Keun-Wook Lee1, Jee Hyun Kim1, Soo-Mee Bang1, Jong-Seok Lee1, Jeong-Ok Lee1
1Department of Internal Medicine, 2Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence to: Jeong-Ok Lee, M.D., Ph.D.
Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam 13620, Korea
E-mail: jeongok77@gmail.com
Published online: November 22, 2021.
© The Korean Journal of Hematology. All rights reserved.

Background: High-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) as a consolidation treatment is a promising approach for eligible patients with newly diagnosed primary central nervous system lymphoma (PCNSL).
Methods: In this retrospective analysis, 22 patients with newly diagnosed PCNSL received chemotherapy with rituximab, methotrexate, procarbazine, and vincristine. Those who showed complete or partial response subsequently received consolidation HDC-ASCT with a thiotepa-based conditioning regimen but did not undergo radiotherapy.
Results: The PCNSL patients had a median age of 57 years (range, 49–67 yr); of the total patients, 9.1% had a performance status of 2 or higher, and 72.1% had multiple lesions. Approximately 82% of patients received six cycles of induction chemotherapy, which was well tolerated with excellent disease control. The rate of confirmed or unconfirmed complete response increased from 45.5% at the period of interim analysis to 81.8% prior to the initiation of HDC-ASCT. With a median follow-up of 19.6 months (range, 7.5–56.5 mo), the 2-year progression-free survival and overall survival estimates were 84% and 88%, respectively. No treatment-related deaths occurred. Grade 3 toxicity was recorded in 90.9% of the patients after undergoing the HDC-ASCT, and the most common grade 3 adverse event was febrile neutropenia without sepsis.
Conclusion: The discussed treatment approach is feasible in patients with newly diagnosed PCNSL, yielding encouraging results.
Keywords: Primary CNS lymphoma, Autologous stem-cell transplantation, Consolidation, Thiotepa


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