Impact of thiotepa dose-intensity in primary diffuse large B-cell lymphoma of the central nervous system undergoing autologous hematopoietic cell transplant with thiotepa/carmustine conditioning Journal Article
| Authors: | Arshad, S.; Fang, X.; Ahn, K. W.; Kaur, M.; Scordo, M.; Sauter, C. S.; Furqan, F.; Awan, F. T.; Hamadani, M. |
| Article Title: | Impact of thiotepa dose-intensity in primary diffuse large B-cell lymphoma of the central nervous system undergoing autologous hematopoietic cell transplant with thiotepa/carmustine conditioning |
| Abstract: | Thiotepa/carmustine (TT-BCNU) is a commonly used autologous transplant (ASCT) conditioning regimen for primary DLBCL of the CNS (PCNSL). The total thiotepa dose varies among TT-BCNU recipients, with some centers administering a total dose of 20 mg/kg, while others using 10 mg/kg. We retrospectively assessed the impact of thiotepa dose intensity on ASCT outcomes in 218 adult PCNSL patients who underwent a first ASCT with TT-BCNU conditioning and received either a total thiotepa dose of 10 mg/kg (TT-10 group; N = 90), or 20 mg/kg (TT-20 group; N = 128). The median follow-up of survivors was 22 months. The cumulative incidence of 1-year non-relapse mortality (NRM) for TT-10 and TT-20 cohorts were 6% (95%CI = 2–12%) vs. 4% (95%CI = 1–8%), respectively (p = 0.66). The 3-year cumulative incidence of relapse (15% vs. 13%; p = 0.67), progression-free survival (PFS) (71% vs. 80%; p = 0.25) and overall survival (OS) (79% vs. 83%; p = 0.56) were similar in the TT-10 and TT-20 groups, respectively. On multivariate analysis compared to TT-10, the TT-20 cohort was not associated with significantly different risk of NRM (Hazard ration [HR] = 0.77; p = 0.64), relapse/progression (HR = 0.87; p = 0.74), PFS (HR = 0.80; p = 0.48) or OS (HR = 1.10; p = 0.80). In conclusion thiotepa dose-intensity in TT-BCNU conditioning does not impact ASCT outcomes of PCNSL patients. © 2023, The Author(s), under exclusive licence to Springer Nature Limited. |
| Keywords: | adult; controlled study; aged; survival rate; retrospective studies; major clinical study; overall survival; mortality; primary central nervous system lymphoma; rituximab; follow up; antineoplastic agent; progression free survival; neutrophil count; neoplasm recurrence, local; antineoplastic combined chemotherapy protocols; cohort analysis; relapse; recurrence; hematopoietic stem cell transplantation; pathology; retrospective study; carmustine; thiotepa; central nervous system tumor; survivor; central nervous system; central nervous system neoplasms; cause of death; tumor recurrence; recurrent disease; multivariate analysis; lymphoma, large b-cell, diffuse; autograft; transplantation, autologous; autologous hematopoietic stem cell transplantation; platelet count; cumulative incidence; autotransplantation; diffuse large b cell lymphoma; autografts; non relapse mortality; humans; human; male; female; article; mortality risk |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 58 |
| Issue: | 11 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2023-11-01 |
| Start Page: | 1203 |
| End Page: | 1208 |
| Language: | English |
| DOI: | 10.1038/s41409-023-02071-8 |
| PUBMED: | 37563283 |
| PROVIDER: | scopus |
| PMCID: | PMC11078515 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
