Treatment of patients with secondary central nervous system lymphoma with high-dose busulfan/thiotepa-based conditioning and autologous stem cell transplant.
Although the survival rates are extremely low for patients with secondary central nervous system lymphoma (SCNSL) treated with conventional chemotherapy and radiotherapy, more encouraging outcomes have recently been reported in small series with high-dose (HD) therapy and autologous stem cell transplant (ASCT). The optimal HD regimen for SCNSL is unknown. Despite reports of thiotepa/busulfan-based conditioning for primary CNS lymphoma, very little data exist regarding the use of this regimen for SCNSL. We analyzed 23 patients with SCNSL (median age 62 years) who underwent ASCT at two Alberta centers using thiotepa, busulfan, cyclophosphamide (TBC) in six patients prior to 2011 and rituximab-busulfan, melphalan, thiotepa (R-BuMelTt) in 17 patients after 2011. At a median follow-up of 27.8 months (4.2-113.6), the 2-year actuarial rate of progression-free survival was 76.1%. In conclusion, our results demonstrate encouraging survival outcomes for patients with SCNSL treated with R-BuMelTt and ASCT.
a Department of Oncology and Medicine , University of Calgary, Tom Baker Cancer Centre , Calgary , AB , Canada.
Danielle H
DH
Oh
b Department of Oncology , University of Alberta, Cross Cancer Institute , Edmonton , AB , Canada.
Neil
N
Chua
a Department of Oncology and Medicine , University of Calgary, Tom Baker Cancer Centre , Calgary , AB , Canada.
Lesley
L
Street
a Department of Oncology and Medicine , University of Calgary, Tom Baker Cancer Centre , Calgary , AB , Canada.
Douglas A
DA
Stewart
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D013852:Thiotepa / Q000008:administration & dosage; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D013852:Thiotepa; D002066:Busulfan
Autologous hematopoietic stem cell transplant; busulfan; secondary CNS lymphoma; thiotepa