Late relapses in primary CNS lymphoma after complete remissions with high-dose methotrexate monotherapy.
Treatment of patients with newly diagnosed primary CNS lymphomas using high dose methotrexate regimens is reported to yield about 30% long term survivors with minimal neurotoxicity. As in other systemic large cell lymphomas, it is generally assumed that most relapses occur within 5 years of diagnosis. A retrospective review of the Johns Hopkins experience in 52 patients treated between 1995 and 2008 yielded 19 patients (37%) who achieved a complete response and were followed for over 5 years. Four of these patients remained progression-free for over 10 years. However, two of these long-term survivors have now relapsed over 10 years after their initial diagnosis. An analysis of progression and overall survival does not reveal a plateau suggesting that even patients who have not recurred for over 10 years remain at high risk for relapse after treatment with single agent high dose methotrexate.
Brain Cancer Program, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD 21287, USA.|Department of Oncology, Johns Hopkins Hospital, 1550 Orleans Street, 1M16, Cancer Research Building II, Baltimore, MD 21287, USA.
Prakash
P
Ambady
Brain Cancer Program, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD 21287, USA.|Department of Oncology, Johns Hopkins Hospital, 1550 Orleans Street, 1M16, Cancer Research Building II, Baltimore, MD 21287, USA.
Matthias
M
Holdhoff
Department of Radiology, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
David
D
Bonekamp
Department of Oncology, Johns Hopkins Hospital, 1550 Orleans Street, 1M16, Cancer Research Building II, Baltimore, MD 21287, USA.
Fay
F
Wong
Brain Cancer Program, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD 21287, USA.|Department of Oncology, Johns Hopkins Hospital, 1550 Orleans Street, 1M16, Cancer Research Building II, Baltimore, MD 21287, USA.
Stuart A
SA
Grossman
D000328:Adult; D000368:Aged; D016543:Central Nervous System Neoplasms / Q000188:drug therapy*; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D008727:Methotrexate