Efficacy and feasibility of autologous stem cell transplantation  in patients with diffuse large B‑cell lymphoma with secondary  central nervous system involvement.
Secondary central nervous system (CNS) involvement is a fatal complication of diffuse large B-cell lymphoma (DLBCL). We evaluated the efficacy and feasibility of high-dose chemotherapy containing busulfan and thiotepa followed by autologous stem cell transplantation (HDC-ASCT) in DLBCL with secondary CNS involvement. Thirty-one patients with secondary CNS involvement including CNS involvement at diagnosis (n = 9), isolated CNS relapse (n = 14), and CNS involvement with systemic disease progression or relapse (n = 8) were selected and analyzed from our prospective cohorts. Of these, 12 patients, including seven with isolated CNS relapse, successfully completed HDC-ASCT without engraftment failure or transplantation-related mortality. After ASCT, six patients were alive; however, three patients experienced post-transplantation relapse. With a median follow-up of 29 months after secondary CNS involvement, the median overall survival of 31 patients was 9 months (95% CI 5–12 months). The survival outcomes of patients who had undergone HDC-ASCT were significantly better than those of patients who did not (p < 0.01). Accordingly, patients with isolated CNS relapse tended to have a longer survival outcome than other cases. Our results suggest that HDC-ASCT may provide survival benefits in DLBCL patients with secondary CNS involvement, especially in case of isolated CNS relapse.
Min-Young
MY
Lee
Hae Su
HS
Kim
Ji Yun
JY
Lee
Sung Hee
SH
Lim
Eun Suk
ES
Kang
Young Hyeh
YH
Ko
Seok Jin
SJ
Kim
Won Seog
WS
Kim
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D064592:Autografts; D002066:Busulfan / Q000008:administration & dosage; D016543:Central Nervous System Neoplasms / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000401:mortality; D015996:Survival Rate; D013852:Thiotepa / Q000008:administration & dosage; D016896:Treatment Outcome
D013852:Thiotepa; D002066:Busulfan