Rituximab, methotrexate, procarbazine and lomustine (R-MPL) for the treatment of primary Central nervous system lymphoma

被引：4

作者：

Lebel, Eyal ^{[1
,2
]}

Goldschmidt, Neta ^{[1
,2
]}

Siegal, Tali ^{[3
]}

Lossos, Alexander ^{[1
,4
]}

Rosenberg, Shai ^{[1
,4
]}

Makranz, Chen ^{[1
,4
]}

Linetski, Eduard ^{[1
,4
]}

Gatt, Moshe E. ^{[1
,2
]}

Gural, Alexander ^{[1
,2
]}

Saban, Revital ^{[1
,2
]}

Lavie, David ^{[1
,2
]}

Vainstein, Vladimir ^{[1
,2
]}

Zimran, Eran ^{[1
,5
]}

Avni, Batia ^{[1
,5
]}

Grisaro, Sigal ^{[1
,5
]}

Shaulov, Adir ^{[1
,2
]}

Nachmias, Boaz ^{[1
,2
]}

机构：

[1] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel

[2] Hadassah Med Ctr, Hematol Dept, Jerusalem, Israel

[3] Rabin Med Ctr, Ctr Neurooncol, Davidoff Inst Oncol, Campus Beilinson, Petah Tiqwa, Israel

[4] Hadassah Med Ctr, Gaffin Ctr Neurooncol, Jerusalem, Israel

[5] Hadassah Med Ctr, Bone Marrow Transplant Dept, Jerusalem, Israel

来源：

LEUKEMIA & LYMPHOMA | 2022年 / 63卷 / 09期

关键词：

Primary CNS lymphoma; methotrexate; procarbazine; lomustine; PRIMARY CNS LYMPHOMA; INTERNATIONAL EXTRANODAL LYMPHOMA; HIGH-DOSE CHEMOTHERAPY; STEM-CELL TRANSPLANTATION; WHOLE-BRAIN RADIOTHERAPY; CYTARABINE; CHEMOIMMUNOTHERAPY; RANDOMIZATION; VINCRISTINE;

D O I：

10.1080/10428194.2022.2064996

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The optimal high-dose methotrexate (HDMTX)-based combination therapy for primary central nervous system lymphoma is unknown. We report our experience with rituximab, HDMTX, procarbazine and lomustine (R-MPL) given as first-line treatment in our center. Fifty-two patients between 2006 and 2019 were included. Eighteen patients proceeded to autologous transplant or two cycles of intermediate-dose cytarabine. The median age was 62 y (range 28-94) and the Eastern Cooperative Oncology Group performance status (ECOG-PS) was >= 2 in 62% (32/52). The overall/complete response rates were 79% (41/52) and 52% (27/52), respectively. The median progression-free/overall survival was 19 m/84m, respectively. Grade 3-4 adverse events included infections (17%) and kidney injury (13%). Ten patients (19%) discontinued therapy for toxicity. There were no treatment-related deaths. In summary, in a cohort enriched in frail patients, R-MPL achieved good responses and OS and was safe for all ages. The PFS was sub-optimal, possibly explained by a low proportion of consolidation. This regimen should be evaluated prospectively.

引用

页码：2102 / 2108

页数：7

共 27 条

[1] Primary central nervous system lymphoma: The Memorial Sloan-Kettering Cancer Center prognostic model [J].

Abrey, Lauren E. ;

Ben-Porat, Leah ;

Panageas, Katherine S. ;

Yahalom, Joachim ;

Berkey, Brian ;

Curran, Walter ;

Schultz, Christopher ;

Leibel, Steven ;

Nelson, Diana ;

Mehta, Minesh ;

DeAngelis, Lisa M. .

JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (36) :5711-5715

[2] Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: An intent-to-treat analysis [J].

Abrey, LE ;

Moskowitz, CH ;

Mason, WP ;

Crump, M ;

Stewart, D ;

Forsyth, P ;

Paleologos, N ;

Correa, DD ;

Anderson, ND ;

Caron, D ;

Zelenetz, A ;

Nimer, SD ;

DeAngelis, LM .

JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (22) :4151-4156

[3] A uniform activated B-cell-like in-immunophenotype might explain the poor prognosis of primary central nervous system lymphomas:: analysis of 83 cases [J].

Camilleri-Broët, S ;

Crinière, E ;

Broët, P ;

Delwail, V ;

Mokhtari, K ;

Moreau, A ;

Kujas, M ;

Raphaël, M ;

Iraqi, W ;

Sautès-Fridman, C ;

Colombat, P ;

Hoang-Xuan, K ;

Martin, A .

BLOOD, 2006, 107 (01) :190-196

[4] Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group study 93-10 [J].

DeAngelis, LM ;

Seiferheld, W ;

Schold, SC ;

Fisher, B ;

Schultz, CJ .

JOURNAL OF CLINICAL ONCOLOGY, 2002, 20 (24) :4643-4648

[5] Prognostic scoring system for primary CNS lymphomas: The international extranodal lymphoma study group experience [J].

Ferreri, AJM ;

Blay, JY ;

Reni, M ;

Pasini, F ;

Spina, M ;

Ambrosetti, A ;

Calderoni, A ;

Rossi, A ;

Vavassori, V ;

Conconi, A ;

Devizzi, L ;

Berger, F ;

Ponzoni, M ;

Borisch, B ;

Tinguely, M ;

Cerati, M ;

Milani, M ;

Orvieto, E ;

Sanchez, J ;

Chevreau, C ;

Dell'Oro, S ;

Zucca, E ;

Cavalli, F .

JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (02) :266-272

[6] Whole-brain radiotherapy or autologous stem-cell transplantation as consolidation strategies after high-dose methotrexate-based chemoimmunotherapy in patients with primary CNS lymphoma: results of the second randomisation of the International Extranodal Lymphoma Study Group-32 phase 2 trial [J].

Ferreri, Andres J. M. ;

Cwynarski, Kate ;

Pulczynski, Elisa ;

Fox, Christopher P. ;

Schorb, Elisabeth ;

La Rosee, Paul ;

Binder, Mascha ;

Fabbri, Alberto ;

Torri, Valter ;

Minacapelli, Eleonora ;

Falautano, Monica ;

Ilariucci, Fiorella ;

Ambrosetti, Achille ;

Roth, Alexander ;

Hemmaway, Claire ;

Johnson, Peter ;

Linton, Kim M. ;

Pukrop, Tobias ;

Gorlov, Jette Sonderskov ;

Balzarotti, Monica ;

Hess, Georg ;

Keller, Ulrich ;

Stilgenbauer, Stephan ;

Panse, Jens ;

Tucci, Alessandra ;

Orsucci, Lorella ;

Pisani, Francesco ;

Levis, Alessandro ;

Krause, Stefan W. ;

Schmoll, Hans J. ;

Hertenstein, Bernd ;

Rummel, Mathias ;

Smith, Jeffery ;

Pfreundschuh, Michael ;

Cabras, Giuseppina ;

Angrilli, Francesco ;

Ponzoni, Maurilio ;

Deckert, Martina ;

Politi, Letterio S. ;

Finke, Juergen ;

Reni, Michele ;

Cavalli, Franco ;

Zucca, Emanuele ;

Illerhaus, Gerald .

LANCET HAEMATOLOGY, 2017, 4 (11) :E510-E523

[7] Chemoimmunotherapy with methotrexate, cytarabine, thiotepa, and rituximab (MATRix regimen) in patients with primary CNS lymphoma: results of the first randomisation of the International Extranodal Lymphoma Study Group-32 (IELSG32) phase 2 trial [J].

Ferreri, Andres J. M. ;

Cwynarski, Kate ;

Pulczynski, Elko ;

Ponzoni, Mourilio ;

Deckert, Martina ;

Politi, Letterio S. ;

Torri, Valter ;

Fox, Christopher P. ;

La Rosee, Paul ;

Schorb, Elisabeth ;

Ambrosetti, Achille ;

Roth, Alexander ;

Hemmoway, Claire ;

Ferrari, Angela ;

Linton, Kim M. ;

Ruda, Roberta ;

Binder, Mascha ;

Pukrop, Tobias ;

Balzarotti, Monica ;

Fabbri, Alberto ;

Johnson, Peter ;

Gorlov, Jette Sonderskov ;

Hess, Georg ;

Panse, Jens ;

Pisani, Francesco ;

Tucci, Alessandra ;

Stilgenbauer, Stephan ;

Hertenstein, Bernd ;

Keller, Ulrich ;

Krause, Stefan W. ;

Levis, Alessandro ;

Schmoll, Hans J. ;

Covalli, Franco ;

Finke, Jurgen ;

Reni, Michele ;

Zucca, Emanuele ;

Illerhaus, Gerald .

LANCET HAEMATOLOGY, 2016, 3 (05) :E217-E227

[8] How I treat primary CNS lymphoma [J].

Ferreri, Andres J. M. .

BLOOD, 2011, 118 (03) :510-522

[9] High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial [J].

Ferreri, Andres J. M. ;

Reni, Michele ;

Foppoli, Marco ;

Martelli, Maurizio ;

Pangalis, Gerasimus A. ;

Frezzato, Maurizio ;

Cabras, Maria Giuseppina ;

Fabbri, Alberto ;

Corazzelli, Gaetano ;

Ilariucci, Fiorella ;

Rossi, Giuseppe ;

Soffietti, Riccardo ;

Stelitano, Caterina ;

Vallisa, Daniele ;

Zaja, Francesco ;

Zoppegno, Lucia ;

Aondio, Gian Marco ;

Avvisati, Giuseppe ;

Balzarotti, Monica ;

Brandes, Alba A. ;

Fajardo, Jose ;

Gomez, Henry ;

Guarini, Attilio ;

Pinotti, Graziella ;

Rigacci, Luigi ;

Uhlmann, Catrina ;

Picozzi, Piero ;

Vezzulli, Paolo ;

Ponzoni, Maurilio ;

Zucca, Emanuele ;

Caligaris-Cappio, Federico ;

Cavalli, Franco .

LANCET, 2009, 374 (9700) :1512-1520

[10] Guidelines for the diagnosis and management of primary central nervous system diffuse large B-cell lymphoma [J].

Fox, Christopher P. ;

Phillips, Elizabeth H. ;

Smith, Jeffery ;

Linton, Kim ;

Gallop-Evans, Eve ;

Hemmaway, Claire ;

Auer, Dorothee P. ;

Fuller, Charlotte ;

Davies, Andrew J. ;

McKay, Pamela ;

Cwynarski, Kate ;

Jones, Gail ;

Pratt, Guy ;

Stern, Simon ;

Lambert, Jonathan ;

Parry-Jones, Nilima ;

McKay, Pam ;

Whiteway, Alastair .

BRITISH JOURNAL OF HAEMATOLOGY, 2019, 184 (03) :348-363

← 1 2 3 →