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

Mary R. Welch, Craig S. Sauter, Matthew J. Matasar, Geraldine Faivre, Susan A. Weaver, Craig H. Moskowitz, Antonio M. Omuro

Research output: Contribution to journalArticle

33 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)361-367
Number of pages7
JournalLeukemia and Lymphoma
Volume56
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • Autologous stem cell transplant
  • Central nervous system lymphoma
  • Chemotherapeutic approaches
  • High-dose chemotherapy
  • Stem cell mobilization

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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