title: Intensive chemotherapy followed by hematopoietic stem-cell rescue for refractory and recurrent primary CNS and intraocular lymphoma: Société Française de Greffe de Moëlle Osseuse-Thérapie Cellulaire.
abstract: OBJECTIVE
  The prognosis of relapsing primary CNS lymphoma (PCNSL) is poor. We report the results of a prospective multicenter trial of intensive chemotherapy followed by autologous hematopoietic stem-cell rescue (IC + HCR) in immunocompetent adult patients with PCNSL or intraocular lymphoma (IOL) after failure of high-dose methotrexate-based treatment.
  
  
  METHODS
  Salvage treatment consisted of two cycles of high-dose cytarabine and etoposide (CYVE). Intensive chemotherapy combined thiotepa, busulfan, and cyclophosphamide. Forty-three patients (median age, 52 years; range, 23 to 65 years) were included, with relapse (n = 22), refractory disease (n = 17), or a partial response to first-line treatment (n = 4). The response to CYVE was not assessable in three cases because of treatment-related death. Twenty patients (47%) were chemosensitive to CYVE: 15 of them proceeded to IC + HCR. IC + HCR was also administered to 12 patients who did not respond to CYVE. All but one of the 27 patients who underwent IC + HCR entered complete remission.
  
  
  RESULTS
  With a median follow-up of 36 months, the median overall survival was 18.3 months in the overall population, and 58.6 months among patients who completed IC + HCR. The respective median progression-free survival (PFS) times after IC + HCR were 11.6 and 41.1 months. The 2-year overall survival probability was 45% in the whole population and 69% among the 27 patients who received IC + HCR. The 2-year PFS probability was 43% among all the patients and 58% in the IC + HCR subpopulation.
  
  
  CONCLUSIONS
  IC + HCR is an effective treatment for refractory and recurrent PCNSL.
authors.affiliation: Department of Hematology, Biostatistics Unit, Centre René Huguenin, Saint-Cloud, France. soussain@crh1.org
authors.forename: Carole
authors.initials: C
authors.lastname: Soussain
authors.forename: Khê
authors.initials: K
authors.lastname: Hoang-Xuan
authors.forename: Luc
authors.initials: L
authors.lastname: Taillandier
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Fourme
authors.forename: Sylvain
authors.initials: S
authors.lastname: Choquet
authors.forename: Francis
authors.initials: F
authors.lastname: Witz
authors.forename: Olivier
authors.initials: O
authors.lastname: Casasnovas
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dupriez
authors.forename: Bertrand
authors.initials: B
authors.lastname: Souleau
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Taksin
authors.forename: Christian
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: Arnaud
authors.initials: A
authors.lastname: Jaccard
authors.forename: Antonio
authors.initials: A
authors.lastname: Omuro
authors.forename: Marc
authors.initials: M
authors.lastname: Sanson
authors.forename: Maud
authors.initials: M
authors.lastname: Janvier
authors.forename: Brigitte
authors.initials: B
authors.lastname: Kolb
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Zini
authors.forename: Véronique
authors.initials: V
authors.lastname: Leblond
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000628:therapy*; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005134:Eye Neoplasms / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000628:therapy*; D011446:Prospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D013852:Thiotepa / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D013852:Thiotepa; D002066:Busulfan