Cargando…

High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study)

To investigate immuno-chemotherapy for elderly immuno-competent patients (⩾65 years) with newly diagnosed primary central nervous system lymphoma, we conducted a multicentre single-arm trial. One cycle consisted of rituximab (375 mg/m(2), days 1, 15, 29), high-dose methotrexate (3 g/m(2) days 2, 16,...

Descripción completa

Detalles Bibliográficos
Autores principales: Fritsch, K, Kasenda, B, Schorb, E, Hau, P, Bloehdorn, J, Möhle, R, Löw, S, Binder, M, Atta, J, Keller, U, Wolf, H-H, Krause, S W, Heß, G, Naumann, R, Sasse, S, Hirt, C, Lamprecht, M, Martens, U, Morgner, A, Panse, J, Frickhofen, N, Röth, A, Hader, C, Deckert, M, Fricker, H, Ihorst, G, Finke, J, Illerhaus, G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383936/
https://www.ncbi.nlm.nih.gov/pubmed/27843136
http://dx.doi.org/10.1038/leu.2016.334
Descripción
Sumario:To investigate immuno-chemotherapy for elderly immuno-competent patients (⩾65 years) with newly diagnosed primary central nervous system lymphoma, we conducted a multicentre single-arm trial. One cycle consisted of rituximab (375 mg/m(2), days 1, 15, 29), high-dose methotrexate (3 g/m(2) days 2, 16, 30), procarbazine (60 mg/m(2) days 2–11) and lomustine (110 mg/m(2), day 2)—R-MPL protocol. Owing to infectious complications, we omitted lomustine during the study and consecutive patients were treated with the R-MP protocol. Three cycles were scheduled and repeated on day 43. Subsequently, patients commenced 4 weekly maintenance treatment with procarbazine (100 mg for 5 days). Primary end point was complete remission (CR) after 3 cycles. We included 107 patients (69 treated with R-MPL and 38 with R-MP). In all, 38/107 patients achieved CR (35.5%) and 15 (14.0%) achieved partial remission. R-MP was associated with a lower CR rate (31.6%) compared with R-MPL (37.7%), but respective 2-year progression-free survival (All 37.3% R-MP 34.9% R-MPL 38.8%) and overall survival (All 47.0% R-MP 47.7% R-MPL 46.0%) rates were similar. R-MP was associated with less ⩾grade 3 toxicities compared with R-MPL (71.1% vs 87.0%). R-MP is more feasible while still associated with similar efficacy compared with R-MPL and warrants further improvement in future studies.