Lucy, 47, explains the impact her diagnosis and treatment has had, and what has helped her recovery. She was told it could be treated by an autologous stem cell transplant (known as an ‘auto’) where her own stem cells would be collected before intensive chemotherapy, then transplanted back to her. doi: 10.1200/JCO.20.10 months ago, Lucy was told she had mantle cell lymphoma, a rare type of non-Hodgkin lymphoma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. Illerhaus G, Marks R, Ihorst G, Guttenberger R, Ostertag C, Derigs G, Frickhofen N, Feuerhake F, Volk B, Finke J. High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. doi: 10.1111/bjh.14073.įerreri AJ, Reni M, Foppoli M, Martelli M, Pangalis GA, Frezzato M, Cabras MG, Fabbri A, Corazzelli G, Ilariucci F, et al. Trends in primary central nervous system lymphoma incidence and survival in the US. Shiels MS, Pfeiffer R, Besson C, Clarke CA, Morton LM, Nogueira L, Pawlish K, Yanik EL, Suneja G, Engels EA. The elderly left behind-changes in survival trends of primary central nervous system lymphoma over the past four decades. ![]() Mendez JS, Ostrom QT, Gittleman H, Kruchko C, DeAngelis LM, Barnholtz-Sloan JS, Grommes C. Lyon: International Agency for Research on Cancer 2017, 585 p (World Health Organization classification of tumours). ![]() editors: WHO classification of tumours of haematopoietic and lymphoid tissues. Swerdlow SH CE, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. German clinical trials registry DRKS00011932 registered 18 August 2017.Īutologous stem cell transplantation (ASCT) Elderly patients High-dose chemotherapy (HDT) Primary central nervous system lymphoma (PCNSL). Minimal follow-up after treatment completion is 12 months.Ĭurrent treatment options for PCNSL have improved over the last years, resulting in the potential to achieve durable remission or cure in patients 65 years with newly-diagnosed PCNSL. Secondary endpoints include PFS, overall survival, treatment response and treatment-related morbidities. The primary endpoint of this study is 1-year progression-free survival (PFS). After 2 cycles of induction chemotherapy, patients achieving at least stable disease will undergo HDT-ASCT with busulfan 3.2 mg/kg/d (days - 7-(- 6)) and thiotepa 5 mg/kg/d (days - 5-(- 4)) followed by autologous stem cell transplantation. All enrolled patients will undergo induction chemotherapy consisting of 2 cycles of rituximab 375 mg/m 2/d (days 0 & 4), methotrexate 3.5 g/m 2 (d1), and cytarabine 2 × 2 g/m 2/d (d2-3) every 21 days. The objective is to investigate the efficacy of age-adapted induction treatment followed by HDT-ASCT. We will recruit 51 immuno-competent patients with newly diagnosed PCNSL from 12 German centers. ![]() This is an open-label, multicentric, non-randomized, single arm phase II trial. Usually, intensive treatment approaches including high-dose chemotherapy followed by autologous stem cell transplantation (HDT-ASCT) are only offered to patients younger than 65-70 years of age. Although elderly patients are able to tolerate aggressive systemic chemotherapy, previous studies have demonstrated inferior outcomes for patients who present with a poor performance status (PS) and older age. Primary central nervous system lymphoma (PCNSL) is a diffuse large B-cell lymphoma (DLBCL) confined to the central nervous system (CNS) with rising incidence among patients > 65 years.
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