Autologous stem cell transplant in recurrent or refractory primary or secondary central nervous system lymphoma using thiotepa, busulfan and cyclophosphamide Journal Article

  

Authors:	Welch, M. R.; Sauter, C. S.; Matasar, M. J.; Faivre, G.; Weaver, S. A.; Moskowitz, C. H.; Omuro, A. M.
Article Title:	Autologous stem cell transplant in recurrent or refractory primary or secondary central nervous system lymphoma using thiotepa, busulfan and cyclophosphamide
Abstract:	The prognosis for patients with central nervous system (CNS) involvement by recurrent or refractory diffuse large B-cell lymphoma is poor, with overall survival (OS) of 4-10 months. High-dose chemotherapy (HDC) and autologous stem cell transplant (ASCT) is a potential treatment alternative. We reviewed patients with recurrent primary (PCNSL) or secondary (SCNSL) CNS lymphoma referred for consolidation HDC-ASCT utilizing thiotepa, busulfan and cyclophosphamide (TBC). Among the 17 patients included, all had achieved a complete remission after salvage induction chemotherapy, which incorporated methotrexate in 82% of patients. Two patients failed stem-cell harvesting and 15 (88%) underwent transplant. The estimated 3-year progression-free survival (PFS) and OS were both 93% (95% confidence interval 61-99%). Median PFS and OS were not reached. There was no transplant-related mortality. These results confirm the benefit of TBC followed by ASCT in select patients with recurrent PCNSL and suggest a potential role for the regimen in those with SCNSL. Further investigation is warranted. © 2014 Informa UK, Ltd.
Keywords:	adult; cancer chemotherapy; cancer survival; clinical article; middle aged; overall survival; busulfan; prednisone; fatigue; cancer recurrence; doxorubicin; diarrhea; treatment duration; cancer patient; cancer radiotherapy; primary central nervous system lymphoma; cytarabine; methotrexate; rituximab; temozolomide; drug megadose; carboplatin; progression free survival; etoposide; mucosa inflammation; cyclophosphamide; melphalan; vincristine; autologous stem cell transplantation; retrospective study; cancer therapy; cancer mortality; carmustine; ifosfamide; procarbazine; thiotepa; central nervous system tumor; febrile neutropenia; cancer regression; stem cell mobilization; colitis; mesna; granulocyte colony stimulating factor; plerixafor; induction chemotherapy; pericarditis; autologous stem cell transplant; high-dose chemotherapy; central nervous system lymphoma; consolidation chemotherapy; chemotherapeutic approaches; human; male; female; priority journal; article; secondary central nervous system lymphoma
Journal Title:	Leukemia and Lymphoma
Volume:	56
Issue:	2
ISSN:	1042-8194
Publisher:	Taylor & Francis Group
Date Published:	2015-02-01
Start Page:	361
End Page:	367
Language:	English
DOI:	10.3109/10428194.2014.916800
PROVIDER:	scopus
PUBMED:	24745937
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84923929088&partnerID=40&md5=5cf6ee965fbfb6837c25b25e58be983f
Notes:	Export Date: 2 April 2015 -- Source: Scopus

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