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Lymphoma

High-dose thiotepa-based chemotherapy with autologous stem cell support in elderly patients with primary central nervous system lymphoma: a European retrospective study

Bone Marrow Transplantation volume 52, pages 1113–1119 (2017)Cite this article

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Abstract

In this retrospective multicentre study, we investigated the outcomes of elderly primary central nervous system lymphoma (PCNSL) patients (⩾65 years) who underwent high-dose chemotherapy followed by autologous stem cell transplantation (HDT-ASCT) at 11 centres between 2003 and 2016. End points included remission, progression-free survival (PFS), overall survival (OS) and treatment-related mortality. We identified 52 patients (median age 68.5 years, median Karnofsky Performance Status before HDT-ASCT 80%) who all underwent thiotepa-based HDT-ASCT. Fifteen patients (28.8%) received HDT-ASCT as first-line treatment and 37 (71.2%) received it as second or subsequent line. Remission status before HDT-ASCT was: CR 34.6%, PR 51.9%, stable disease 3.8% and progressive disease 9.6%. Following completion of HDT-ASCT, 36 patients (69.2%) achieved CR (21.2% first-line setting and 48.1% second or subsequent line setting) and 9 (17.3%) PR (5.8% first-line setting and 11.5% second or subsequent line setting). With a median follow-up of 22 months after HDT-ASCT, median PFS and OS were reached after 51.1 and 122.3 months, respectively. The 2-year PFS and OS rates were 62.0% and 70.8%, respectively. We observed two HDT-ASCT-associated deaths (3.8%). In selected elderly PCNSL patients, HDT-ASCT, using thiotepa-based conditioning regimes, is feasible and effective. Further prospective and comparative studies are warranted to further evaluate the role of HDT-ASCT in elderly PCNSL patients.

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Acknowledgements

We thank the contributions of all participating centres.

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Author notes

  1. E Schorb, C P Fox, C Soussain and B Kasenda: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    E Schorb, K Fritsch & L Isbell

  2. Department of Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK

    C P Fox & R Witherall

  3. Stuttgart Cancer Centre, Klinikum Stuttgart, Stuttgart, Germany

    A Neubauer, A Tzalavras, G Illerhaus & B Kasenda

  4. Department of Haematology, APHP, Sorbonne Universités, Hospital Pitié-Salpêtrière, Paris, France

    S Choquet

  5. Department of Oncology, Oulu University Hospital, Oulu, Finland

    O Kuittinen

  6. Department of Haematology, University College Hospital, London, UK

    D De-Silva & K Cwynarski

  7. Department of Neurology, APHP, Sorbonne Universités, UPMC Hospital Pitié-Salpêtrière, LOC network, Paris, France

    C Houillier & K Hoang-Xuan

  8. Department of Ophthalmolgy, APHP, Sorbonne Universités, UPMC Hospital Pitié-Salpêtrière, LOC network, Paris, France

    V Touitou

  9. Department of Ophthalmology, Curie Institute–Rene Huguenin Hospital, LOC network, Saint-Cloud, France

    N Cassoux

  10. Department of Haematology, University Hospital, Amiens, LOC network, Amiens, France

    J-P Marolleau

  11. Department of Haematology, Cochin University Hospital, LOC network, Paris, France

    J Tamburini

  12. Department of Haematology, University Hospital, LOC network, Rennes, France

    R Houot

  13. Department of Haematology, University Hospital, LCO network, Poitiers, France

    V Delwail

  14. Department of Haematology, Curie Institute-Rene Huguenin Hospital, LOC network, Saint-Cloud, France

    C Soussain

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  1. E Schorb
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  2. C P Fox
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Schorb, E., Fox, C., Fritsch, K. et al. High-dose thiotepa-based chemotherapy with autologous stem cell support in elderly patients with primary central nervous system lymphoma: a European retrospective study. Bone Marrow Transplant 52, 1113–1119 (2017). https://doi.org/10.1038/bmt.2017.23

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