title: Constant pattern of relapse in primary central nervous lymphoma patients treated with high-dose methotrexate combinations. A Finnish retrospective study.
abstract: BACKGROUND
  Primary central nervous system lymphoma (PCNSL) is a rare brain tumour with a dismal prognosis. Several phase II studies with high-dose methotrexate-based regimens have shown promising early results, but in all hospital-based data published so far, the disease outcome is poor.
  
  
  METHODS
  We performed a hospital-based retrospective analysis to evaluate the long-term results of the Nordic type of Bonn chemotherapy regimen in PCNSL patients. The study included 54 patients with newly diagnosed PCNSL who received chemotherapy with curative intent as their first-line treatment.
  
  
  RESULTS
  We found promising response rates, 76% of the patients achieving CR and 22% patients achieving PR, with corresponding two-year EFS 53% and OS 76%. However, with longer follow-up a constant pattern of relapses was observed with only one patient remaining in primary remission after 60 months.
  
  
  CONCLUSIONS
  The finding suggests that basic biological differences exist between PCNSL and systemic diffuse large B-cell lymphoma and there is a need for consolidation or maintenance therapy after achieving a remission in patients with PCNSL.
authors.affiliation: Oulu University Hospital, Department of Oncology and Radiotherapy, Oulu University , Oulu , Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Harjama
authors.forename: Hanne
authors.initials: H
authors.lastname: Kuitunen
authors.forename: Taina
authors.initials: T
authors.lastname: Turpeenniemi-Hujanen
authors.forename: Kirsi Maria
authors.initials: KM
authors.lastname: Haapasaari
authors.forename: Sirpa
authors.initials: S
authors.lastname: Leppä
authors.forename: Susanna
authors.initials: S
authors.lastname: Mannisto
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Karjalainen-Lindsberg
authors.forename: Tuula
authors.initials: T
authors.lastname: Lehtinen
authors.forename: Mine
authors.initials: M
authors.lastname: Eray
authors.forename: Martine
authors.initials: M
authors.lastname: Vornanen
authors.forename: Hannu
authors.initials: H
authors.lastname: Haapasalo
authors.forename: Ylermi
authors.initials: Y
authors.lastname: Soini
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
authors.forename: Tapio
authors.initials: T
authors.lastname: Nousiainen
authors.forename: Kaija
authors.initials: K
authors.lastname: Vasala
authors.forename: Outi
authors.initials: O
authors.lastname: Kuittinen
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005387:Finland; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D000069283:Rituximab; D008727:Methotrexate