Clinical characteristics and survival outcomes of patients with primary central nervous system lymphoma treated with high-dose methotrexate-based polychemotherapy and consolidation therapies

作者：Fleur A. de Groot, Tim Dekker, Jeanette K. Doorduijn, Stefan Böhringer, Mirian Brink, Ruben A. L. de Groen, Lorraine M. de Haan, Feng Jung Sherida H. Woei-A-Jin, Troy Noordenbos, Anikó Sijs‐Szabó, Mirjam A. Oudshoorn, King H. Lam, Arjan Diepstra, L.C.J. te Boome, Valeska Terpstra, Lara H. Böhmer, Alina Nicolae, Eduardus F. M. Posthuma, Lianne Koens, Marc Durian, Jeroen Stavast, Marjolein W.M. van der Poel, Myrurgia Abdul Hamid, Wendy B.C. Stevens, Sjo L M van Rooij, Rimke Oostvogels, Angelika Mühlebner, Karen J. Neelis, Michiel van den Brand, Thomas Tousseyn, Daan Dierickx, Okke de Weerdt, Aart Beeker, Patty M. Jansen, Marie José Kersten, Josée M. Zijlstra, Martine E.D. Chamuleau, Hendrik Veelken, Jacoline E. C. Bromberg, Marcel Nijland, Joost S.P. Vermaat · 发表于：European Journal of Cancer · 年份：2024 · DOI：10.1016/j.ejca.2024.115068 · 被引用次数：12 · 研究领域：CNS Lymphoma Diagnosis and Treatment、Lymphoma Diagnosis and Treatment、Glioma Diagnosis and Treatment

Given the rarity of primary central nervous system lymphoma (PCNSL), evaluations of different high-dose methotrexate-(HD-MTX)-based treatment regimens is sparse. This retrospective, multicenter study evaluates clinical characteristics and outcomes (progression-free, overall and disease-specific survival) after five HD-MTX-based polychemotherapeutic regimens and two consolidation therapies. 346 patients with histologically confirmed PCNSL, treated with ≥ 1 cycle HD-MTX-based strategies (≥3g/m 2 /cycle) were included. The regimens included MATRIX (HD-MTX, HD-AraC, thiotepa, and rituximab), (R)MBVP±HD-AraC (HD-MTX, teniposide/etoposide, carmustine, prednisolone, ± HD-AraC, ± rituximab), (R)MP (HD-MTX, procarbazine, ± rituximab), and a combination of HD-MTX and HD-AraC. The overall response rate after induction was 69 %, 28 % complete remission and progressive disease was observed in 100 (29 %) patients. 126 (36 %) patients received consolidation, including high-dose-BCNU-thiotepa with autologous stem cell transplantation (HD-BCNU-TT/ASCT, n = 59 (17 %)) or whole brain radiotherapy (WBRT, n = 67 (19 %)). Clinical characteristics associated with adverse mortality risk by multivariable prognostication contained age > 60 years (HR 1.61, p = 0.011), elevated LDH (HR 1.75, p = 0.004) and WHO status ≥ 2 (HR 1.56, p = 0.010). Independently, induction regimens containing HD-AraC demonstrated survival benefit compared to induction regimens without HD-AraC (HR 0.59, p = 0.002). Without pre...