title: Haematopoietic stem cell transplantation for treatment of primary CNS lymphoma: single-centre experience and literature review.
abstract: Primary central nervous system lymphoma (PCNSL) is a rare and malignant tumour type. Established treatment approaches include high-dose methotrexate (HD-MTX)-based chemotherapy and whole-brain radiotherapy (WBRT). WBRT is associated with significant neurotoxicity and autologous haematopoietic stem cell transplantation (ASCT) has been proposed as an alternative treatment - either in the 1st line setting after HD-MTX-based chemotherapy or as salvage treatment for relapsed/refractory PCNSL. We here report our single-centre experience with five PCNSL patients, who had achieved an objective response after a high-dose methotrexate-based induction therapy and consecutively received a high-dose chemotherapy, consisting of carmustine and thiotepa, followed by ASCT. We also provide a literature review on ASCL for PCNSL. Our data, with three of five patients in continuous complete remission and four of five patients alive after a median follow-up time of 8 months, as well as previously published results, show that ASCT is a safe treatment option that is able to induce tumour remissions in patients with PCNSL. However, controlled trials are needed to compare the long-term efficacy and tolerability of ASCT with other treatment approaches and also to establish the optimal sequence of treatment regimens in PCNSL patients.
authors.affiliation: Unit for Bone Marrow and Stem Cell Transplantation, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Marija
authors.initials: M
authors.lastname: Bojic
authors.affiliation: Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Berghoff
authors.affiliation: Unit for Bone Marrow and Stem Cell Transplantation, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Marlene
authors.initials: M
authors.lastname: Troch
authors.affiliation: Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: Hermine
authors.initials: H
authors.lastname: Agis
authors.affiliation: Department of Medicine I, Clinical Division of Haematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Sperr
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Widhalm
authors.affiliation: Institute of Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Adelheid
authors.initials: A
authors.lastname: Wöhrer
authors.affiliation: Unit for Bone Marrow and Stem Cell Transplantation, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
authors.affiliation: Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
authors.affiliation: Unit for Bone Marrow and Stem Cell Transplantation, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002330:Carmustine / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D013852:Thiotepa / Q000627:therapeutic use; D014182:Transplantation, Autologous
chemical_list: D013852:Thiotepa; D002330:Carmustine; D008727:Methotrexate
keywords: autologous haematopoietic stem cell transplantation; high-dose chemotherapy; primary central nervous system lymphoma; review