title: Ranimustine, ifosfamide, procarbazine, dexamethasone, and etoposide therapy for central nervous system recurrence of diffuse large B-cell lymphoma in patients with poor performance status: a pilot study.
abstract: The prognosis of patients with diffuse large B-cell lymphoma with central nervous system (CNS) involvement is still poor. We performed a pilot study to establish treatment for patients who had refractory or recurrent CNS involvement without employing high-dose chemotherapy or stem cell support. Eight patients with diffuse large B-cell lymphoma and CNS disease after first-line chemotherapy were enrolled. They were treated with MIND-E therapy (ranimustine, ifosfamide, procarbazine, dexamethasone, and etoposide) every 4 weeks. Three patients achieved complete remission, two patients achieved partial remission, and three patients did not respond. One patient received an autologous peripheral stem cell transplant after MIND-E therapy. Three patients are still alive. In conclusion, MIND-E therapy was effective for CNS disease in patients with B-cell lymphoma who were judged to be poor candidates for intensive chemotherapy. Its toxicity was tolerable. A prospective study should be done to confirm the efficacy of this regimen.
authors.affiliation: Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Miwa
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sekiguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Tanimura
authors.forename: Chiho
authors.initials: C
authors.lastname: Homma
authors.forename: Tateki
authors.initials: T
authors.lastname: Shikai
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Takezako
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamagata
authors.forename: Naoki
authors.initials: N
authors.lastname: Takezako
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality; D003907:Dexamethasone / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000627:therapeutic use; D010865:Pilot Projects; D011344:Procarbazine / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D009607:Nitrosourea Compounds; D011344:Procarbazine; D005047:Etoposide; D003907:Dexamethasone; C020766:ranimustine; D007069:Ifosfamide