Treatment of primary intraocular lymphoma with oral trofosfamide: report of two cases and review of the literature.
BACKGROUND
The prognosis of primary intraocular lymphoma (PIOL) is poor. Due to frequent ocular and/or CNS relapses, the optimal treatment for PIOL has not yet been defined. This is the first report of PIOL treatment with trofosfamide.


METHODS
The first patient with a newly diagnosed PIOL was not considered eligible for high-dose methotrexate-based systemic chemotherapy due to comorbidities. The second patient had a primary central nervous system lymphoma, which was resistant to three chemotherapy regimens and responded to whole-brain irradiation. A tumor relapse in the eye was treated with local radiotherapy with initial success; however, the tumor subsequently recurred. The first patient received oral trofosfamide 150 mg daily, the second 400 mg daily (reduced after 5 months of therapy to 300 mg daily) over 5 consecutive days, followed by a 5-day drug-free interval.


RESULTS
In both patients, complete remission was achieved, which lasted for 8+ and 18 months, respectively. Except for a temporary asymptomatic decrease in hemoglobin in the first patient, no toxicity was observed.


CONCLUSIONS
Trofosfamide may offer an alternative treatment option for PIOL with a very favorable side effect profile. The exact role of trofosfamide in the treatment of PIOL remains to be defined.
Jahnke
Kristoph
K
Department of Hematology, Oncology and Transfusion Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. kristoph.jahnke@charite.de
Bechrakis
Nikolaos E
NE
Coupland
Sarah E
SE
Schmittel
Alexander
A
Foerster
Michael H
MH
Fischer
Lars
L
Thiel
Eckhard
E
Korfel
Agnieszka
A
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001932:Brain Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D002830:Choroid Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged
D018906:Antineoplastic Agents, Alkylating; D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; C003726:trofosfamide