title: Prognosis after high-dose chemotherapy followed by autologous stem-cell transplantation as first-line treatment in primary CNS lymphoma--a long-term follow-up study.
abstract: BACKGROUND
  High-dose chemotherapy followed by autologous stem-cell transplantation (HCT-ASCT) is a promising approach in eligible patients with primary central nervous system lymphoma (PCNSL). We report long-term data of patients who were treated according to HCT-ASCT containing protocols.
  
  
  METHODS
  We analyzed survival and relapse rates in 43 (<67 years) immunocompetent patients with newly diagnosed PCNSL being treated according to two different high-dose methotrexate-based protocols followed by high-dose carmustine/thiotepa (BCNU/TT) plus ASCT (±whole brain irradiation). Analysis was conducted for all patients (intention-to-treat) and those patients who actually received HCT-ASCT (per-protocol).
  
  
  RESULTS
  Thirty-four patients achieved complete remission, of those 12 relapsed (35%), while 6 of them relapsed 5 years after diagnosis. After a median follow-up of 120 months, median overall survival (OS) was reached after 104 months. Two- and 5-year OS was 81% and 70% and 2- and 5-year event-free survival (EFS) was 81% and 67%, respectively. In per-protocol analysis (N = 34), 5-year OS and EFS was 82% and 79%, respectively. HCT-ASCT associated related mortality was not observed.
  
  
  CONCLUSIONS
  Sequential high-dose MTX containing chemotherapy followed by high-dose carmustine/thiotepa plus ASCT (±whole brain irradiation) is safe and leads to high survival rates in eligible patients with newly diagnosed PCNSL.
authors.affiliation: Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany; Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Kasenda
authors.affiliation: Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Schorb
authors.affiliation: Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Fritsch
authors.affiliation: Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Finke
authors.affiliation: Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany. Electronic address: gerald.illerhaus@uniklinik-freiburg.de.
authors.forename: G
authors.initials: G
authors.lastname: Illerhaus
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D033581:Stem Cell Transplantation; D013852:Thiotepa / Q000008:administration & dosage
chemical_list: D013852:Thiotepa; D002330:Carmustine