Consolidation With Autologous Stem Cell Transplantation In Patients With Primary Central Nervous System Lymphoma

Bahar Uncu Ulu, D. Şahin, T. Yiğenoğlu, T. Darçın, M. Bakırtaş, S. Başcı, J. Yıldız, D. İskender, N. A. Baysal, M. Kızıl Çakar, M. Dal, F. Altuntaş
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Abstract

Introduction: Primary central nervous system lymphomas (PCNSL) are defined as a rare extranodal Non-Hodgkin lymphoma subgroup. The induction regimens involve high dose methotrexate-based chemotherapies mostly for the patients with PCNSL. There is still no standard approach for consolidation therapy. Recently, consolidation with autologous stem cell transplantation (ASCT) after high-dose chemotherapy has been widely used in the treatment of PCNSL. We aim to evaluate the results of PCNS patients who underwent ASCT in our center. Methods: The data of PCNSL patients diagnosed in Hematology Unit of Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital between 2010 and 2021 were analyzed retrospectively. Results: Eleven patients were diagnosed with PCNSL diagnosis. The patients' median age included in the study was 53.5 years (range 38-68). Eight patients underwent ASCT for upfront consolidation. Seven patients achieved CR three months after ASCT; one patient was not evaluated due to exitus in the first month of the transplant. Three patients could not achieve ASCT due to transplantation ineligibility patients and mobilization failure. The median follow-up period in the study was 26 months (range 8-82 months). The median overall survival was not reached. Transplant-related mortality was 12.5%, and the mortality rate was 27% in the whole cohort. In patients who received ASCT, of the 62.5% had an almost two-year survival advantage. For the whole cohort, 73% of the patients had change for more prolonged survival among follow-up. Discussion and conclusion: In our cohort, the PCNSL patients had mostly high-risk disease; however, three-quarters of the patients could receive ASCT, and at the same rate of the patients had advantages for long-term survival.
自体干细胞移植治疗原发性中枢神经系统淋巴瘤
原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的结外非霍奇金淋巴瘤亚组。诱导方案包括大剂量甲氨蝶呤为主的化疗,主要用于PCNSL患者。巩固治疗仍然没有标准的方法。近年来,自体干细胞移植(ASCT)在大剂量化疗后的巩固已被广泛应用于PCNSL的治疗。我们的目的是评估在本中心接受ASCT的PCNS患者的结果。方法:回顾性分析2010 - 2021年Dr. Abdurrahman Yurtaslan安卡拉肿瘤医院血液科诊断的PCNSL患者资料。结果:11例患者确诊为PCNSL。纳入研究的患者中位年龄为53.5岁(38-68岁)。8例患者行ASCT进行前期巩固。7例ASCT术后3个月达到CR;1例患者在移植的第一个月因退出而未进行评估。3例患者由于移植不合格患者和活动失败未能实现ASCT。研究的中位随访期为26个月(8-82个月)。中位总生存期未达到。移植相关死亡率为12.5%,整个队列的死亡率为27%。在接受ASCT的患者中,62.5%的患者有近两年的生存优势。在整个队列中,73%的患者在随访期间改变了生存时间。讨论与结论:在我们的队列中,PCNSL患者多为高危疾病;然而,四分之三的患者可以接受ASCT,并且在相同的比例下,患者具有长期生存的优势。
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