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Treatment with methotrexate, rituximab, and cytosine arabinoside followed by autologous stem cell transplantation in primary central nervous system lymphoma: A single-center experience

Atilla, Pinar Ataca (Corresponding author at: Department of Hematology & BMT Unit, School of Medicine, Ankara University, Cebeci Hospital, Dikimevi, Ankara 06590, Turkey. ) ; Atilla, Erden ; Bozdag, Sinem Civriz ; Yuksel, Meltem Kurt ; Toprak, Selami Kocak ; Topcuoglu, Pervin ; Demirer, Taner ; Ilhan, Osman ; Arslan, Onder ; Gurman, Gunhan ; Ozcan, Muhit ;
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    Abstract Objective/Background Primary central nervous system lymphoma (PCNSL) is associated with worst prognosis compared with other aggressive non-Hodgkin’s lymphomas. However, recent trials have demonstrated that long-term progression-free survival can be achieved by immunochemotherapy. Our goal is to present our experience in aggressive PCNSL in this study. Methods We retrospectively evaluated the clinical features and management of 13 PCNSL patients who were diagnosed and treated between 2006 and 2015. Results Nine patients received rituximab (R) 375mg/m 2 /day on Day 1, methotrexate (MTX) 3.5g/m 2 /day and cytosine arabinoside (ARA-C) 4.4g/m 2 /day on Day 2, as well as ARA-C 4.4g/m 2 /day on Day 3 every 28days, and underwent autologous stem cell transplantation. Two patients received procarbazine instead of ARA-C. One patient relapsed, and allogeneic hematopoietic stem cell transplantation was performed. All nine patients are followed in complete remission. Two of 13 patients received one course of MTX and 36–45Gy radiotherapy and died. One patient with renal transplantation had progressive disease and died. Grade 3–4 hematological toxicity was detected in 11 (85%), Grade 3–4 mucositis in 11 (85%), and febrile neutropenia in 12 (92%) patients. The median overall survival in the R–MTX–ARA-C/procarbazine group was 28±16months. Conclusion R–MTX–ARA-C followed by autologous stem cell transplantation seems a promising strategy with high response rates in PCNSL.


  • 주제어

    Autologous stem cell transplantation .   Cytosine arabinoside .   Methotrexate .   Primary central nervous system lymphoma .   Rituximab.  

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