Outcomes of Autologous Stem Cell Transplant in Primary and Secondary Central Nervous System Lymphoma - a Multi Center Experience in Singapore

作者：M Tan, Jing Yuan Tan, Melinda Si Yun Tan, Chieh Hwee Ang, Yunxin Chen, Jeffrey Kim Siang Quek, Tertius Tuy, Hein Than, Chandramouli Nagarajan, Francesca Lim, Yeow Tee Goh, Aloysius Ho, Yeh Ching Linn, William Ying Khee Hwang, Victor Ling, Liang Piu Koh, Lip Kun Tan, Joanne Shu Xian Lee, Esther Hian Li Chan, Sanjay De Mel, Michelle Poon, Lawrence Cheng Kiat Ng · 发表于：Blood · 年份：2024 · DOI：10.1182/blood-2024-205120 · 研究领域：CNS Lymphoma Diagnosis and Treatment

Introduction Central Nervous System Lymphoma, either primary (PCNSL) or secondary (SCNSL), is a rare and aggressive extranodal lymphoma with poor outcomes due to poor blood-brain barrier penetrance, treatment associated neurotoxicity, and heterogeneity of presentations. While thiotepa-based autologous stem cell transplant (ASCT) has shown effectiveness in treating CNSL, a proportion of patients relapse, highlighting the need to refine treatment strategies. Aim/Methods To evaluate survival outcomes of patients with primary and secondary CNSL who underwent thiotepa-based ASCT between 2013 and 2023 at Singapore's two largest national cancer centers, as either first-line consolidation or treatment for relapse or refractory (RR) disease. Results There were 61 patients included in this study, 34 patients with primary CNSL (cohort A) and 27 patients with secondary CNSL (cohort B). Non relapse mortality (NRM) were 8.1% for all patients. For cohort A, median age at transplant was 59.5 years (27-75) evenly split between males and females (17 each). Among these patients, 30 (88.2%) had an ECOG Performance Status of 0-1, while 3 (8.8%) had an ECOG of 2-3. Of the 34 patients, 25 (73.5%) received ASCT as first-line consolidation, and 9 (26.5%) underwent ASCT for relapse or refractory disease. All but one patient received thiotepa-carmustine conditioning; the exception received thiotepa-busulfan. Disease status at transplant included Complete Response (CR) in 22 patients (64.7%), Partial Re...