title: Treatment of newly diagnosed B-cell origin primary CNS lymphoma with systemic R-IDARAM chemotherapy and intrathecal immunochemotherapy.
abstract: BACKGROUND
  Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin's lymphoma (NHL). The aim was to evaluate response rate, progression free survival (PFS), overall survival (OS), and toxicity in PCNSL after systemic R-IDARAM and intrathecal immunochemotherapy with deferred radiotherapy.
  
  
  RESULTS
  The response rate was 94% with 17 (89%) complete responses and 1 (5%) partial responses. Follow-up time is from 5 to 63 months (median, 39 months). Median survival has not been reached. 3-year overall survival and progression-free survival rates were 84.2% (CI 72.6% to 99.8%) and 63.2% (CI 41.4% to 73.8%). Systemic toxicity was mainly hematologic. Neurocognitive and neuromotor deterioration as a result of treatment occurred in only one patient (5%).
  
  
  METHODS
  From September 2010 to June 2015, 19 consecutive patients with PCNSL (median age, 54 years) were enrolled into a pilot phase II study evaluating immunochemotherapy without radiotherapy. The patients were accrued to a chemotherapy regimen that incorporated rituximab, idarubicin, dexamethasone, cytarabine (Ara-c) and methotrexate (MTX) combined with intrathecal rituximab, MTX, dexamethasone and Ara-c.
  
  
  CONCLUSIONS
  The results indicate that R-IDARAM regimen with intrathecal immunochemotherapy is generally well tolerated and produces a high complete response rate and survival rate.
authors.affiliation: Department of Hematology, Navy General Hospital, Beijing, PR China.
authors.forename: Liren
authors.initials: L
authors.lastname: Qian
authors.affiliation: Department of Neurosurgery, Navy General Hospital, Beijing, PR China.
authors.forename: Chunhui
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Hematology, Navy General Hospital, Beijing, PR China.
authors.forename: Jianliang
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Hematology, Navy General Hospital, Beijing, PR China.
authors.forename: Jian
authors.initials: J
authors.lastname: Cen
authors.affiliation: Department of Hematology, Navy General Hospital, Beijing, PR China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007167:Immunotherapy / Q000379:methods; D007278:Injections, Spinal; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D010865:Pilot Projects; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D000069283:Rituximab; D003907:Dexamethasone; D008727:Methotrexate; D015255:Idarubicin
keywords: R-IDARAM; diffuse large B-cell lymphoma; immunochemotherapy; primary CNS lymphoma; rituximab