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:
Notes: Export Date: 2 April 2015 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Craig Moskowitz
    375 Moskowitz
  2. Antonio Marcilio Padula Omuro
    177 Omuro
  3. Mary Welch
    10 Welch
  4. Craig Steven Sauter
    167 Sauter
  5. Sarah A Weaver
    6 Weaver
  6. Matthew J Matasar
    122 Matasar
  7. Geraldine M Faivre
    7 Faivre