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

被引：16

作者：

Schenone, Laurence ^{[1
]}

Houillier, Caroline ^{[2
]}

Tanguy, Marie Laure ^{[3
]}

Choquet, Sylvain ^{[4
]}

Agbetiafa, Kossi ^{[5
]}

Ghesquieres, Herve ^{[6
]}

Damaj, Gandhi ^{[7
]}

Schmitt, Anna ^{[8
]}

Bouabdallah, Krimo ^{[9
]}

Ahle, Guido ^{[10
]}

Gressin, Remy ^{[11
]}

Cornillon, Jerome ^{[12
]}

Houot, Roch ^{[13
]}

Marolleau, Jean-Pierre ^{[14
]}

Fornecker, Luc-Matthieu ^{[15
]}

Chinot, Olivier ^{[16
]}

Peyrade, Frederic ^{[17
]}

Bouabdallah, Reda ^{[18
]}

Molucon-Chabrot, Cecile ^{[19
]}

Gyan, Emmanuel ^{[20
]}

Chauchet, Adrien ^{[21
]}

Casasnovas, Olivier ^{[22
]}

Oberic, Lucie ^{[23
]}

Delwail, Vincent ^{[24
]}

Abraham, Julie ^{[25
]}

Roland, Virginie ^{[26
]}

Waultier-Rascalou, Agathe ^{[27
]}

Willems, Lise ^{[28
]}

Morschhauser, Franck ^{[29
]}

Fabbro, Michel ^{[30
]}

Ursu, Renata ^{[31
]}

Thieblemont, Catherine ^{[32
]}

Jardin, Fabrice ^{[33
]}

Tempescul, Adrian ^{[34
]}

Malaise, Denis ^{[35
,36
]}

Touitou, Valerie ^{[37
]}

Nichelli, Lucia ^{[38
]}

Le Garff-Tavernier, Magali ^{[39
]}

Plessier, Aurelie ^{[40
]}

Bourget, Philippe ^{[41
]}

Bonmati, Caroline ^{[42
]}

Wantz-Mezieres, Sophie ^{[43
]}

Giordan, Quentin ^{[44
]}

Dorvaux, Veronique ^{[45
]}

Charron, Cyril ^{[46
]}

Jabeur, Waliyde ^{[47
]}

Hoang-Xuan, Khe ^{[2
]}

Taillandier, Luc ^{[48
]}

Soussain, Carole ^{[5
,49
]}

机构：

[1] Univ Lorraine, Dept Hematol, Hop Brabois, CHRU Nancy, Nancy, France

[2] Sorbonne Univ, Grp Hosp Pitie Salpetriere, AP HP, ICM,IHU,Dept Neurol, Paris, France

[3] Inst Gustave Roussy, Dept Biostat, Paris, France

[4] Sorbonne Univ, Dept Hematol, Hop Pitie Salpetriere, AP HP, Paris, France

[5] Inst Curie, Dept Hematol, Site St Cloud, St Cloud, France

[6] Ctr Hosp Lyon Sud, Dept Hematol, Lyon, France

[7] CHU Caen Normandie, Dept Hematol, Caen, France

[8] Inst Bergonie, Dept Hematol, Bordeaux, France

[9] Univ Hosp Bordeaux, Dept Hematol & Cell Therapy, F-33000 Bordeaux, France

[10] Hop Civils Colmar, Dept Neurol Pole NNORR, Colmar, France

[11] CHU Grenoble, Dept Hematol, Grenoble, France

[12] Inst Cancerol Lucien Neuwirth, Dept Hematol, St Priest En Jarez, France

[13] CHU Rennes, Dept Hematol, Rennes, France

[14] CHU Amiens, Dept Hematol, Amiens, France

[15] Inst Cancerol Strasbourg Europe, Dept Hematol, Strasbourg, France

[16] CHU Timone, AP HM, Dept Neurooncol, Marseille, France

[17] Ctr Antoine Lacassagne, Dept Hematol, Nice, France

[18] Hop Prive Provence, Pole Cancerol, Aix En Provence, France

[19] CHU Clermont Ferrand, Dept Hematol, Clermont Ferrand, France

[20] CHU Tours, Dept Hematol & Cellular Therapy, Tours, France

[21] CHRU Besancon, Dept Hematol, Besancon, France

[22] CHU Dijon Bourgogne, Dept Hematol, Dijon, France

[23] Inst Univ Canc Toulouse, Dept Hematol, Toulouse, France

[24] CHU Poitiers, Dept Hematol & Cellular Therapy, Poitiers, France

[25] CHU Dupuytren Limoges, Dept Hematol, Limoges, France

[26] CH St Jean, Dept Hematol, Perpignan, France

[27] CHU Nimes Caremeau, Dept Hematol, Nimes, France

[28] CHU Paris Ctr, Dept Hematol, Site Cochin, Paris, France

[29] CHRU Lille, Inst Hematol Transfus, Lille, France

[30] Inst Reg Canc Montpellier, Dept Oncol, Montpellier, France

[31] Hop St Louis, AP HP, Dept Neurol, Paris, France

[32] Hop St Louis, AP HP, Dept Hematol, Paris, France

[33] Ctr Henri Becquerel, Dept Hematol, Rouen, France

[34] CHRU Brest, Dept Hematol, Brest, France

[35] Inst Curie, Dept Ophthalmol, Paris, France

[36] PSL Univ, Inst Curie, Lab Imagerie Translat Oncol, Inserm U1288, Orsay, France

[37] Hop La Pitie Salpetriere, AP HP, Dept Ophthalmol, Paris, France

[38] Hop La Pitie Salpetriere, AP HP, Dept Neuroradiol, Paris, France

[39] Hop La Pitie Salpetriere, AP HP, Dept Biol Hematol, Paris, France

[40] Hop Beaujon, AP HP, Dept Hepatogastroenterol, Paris, France

[41] Hop Necker Enfants Malad, AP HP, Dept Funct Explorat, Paris, France

[42] CHRU Nancy, Hop Brabois, Dept Hematol, Nancy, France

[43] Univ Lorraine, IECL, INRIA, CNRS, F-54000 Nancy, France

[44] CHR Metz Thionville, Hop Mercy, Pharm Dept, Metz, France

[45] CHR Metz Thionville, Hop Mercy, Dept Hematol, Metz, France

[46] Univ Hosp Ambroise Pare, AP HP, Intens Care Dept, Boulogne, France

[47] Hop Foch, Dept Neurol, Suresnes, France

[48] CHRU Nancy, Hop Cent, Dept Neurol, Nancy, France

[49] PSL Res Univ, Inst Curie, INSERM U932, Paris, France

来源：

BONE MARROW TRANSPLANTATION | 2022年 / 57卷 / 06期

关键词：

PRIMARY CNS LYMPHOMA; HIGH-DOSE CHEMOTHERAPY; WHOLE-BRAIN RADIOTHERAPY; MARROW-TRANSPLANTATION; INTRAOCULAR LYMPHOMA; POSITION STATEMENT; ELDERLY-PATIENTS; THIOTEPA; CYCLOPHOSPHAMIDE; CONSOLIDATION;

D O I：

10.1038/s41409-022-01648-z

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

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.

引用

页码：966 / 974

页数：9

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