Intensive Methotrexate and Cytarabine Followed by High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Newly Diagnosed Primary CNS Lymphoma: An Intent-to-Treat Analysis

Lauren E Abrey; Craig H Moskowitz; Warren P Mason; Michael Crump; Douglas Stewart; Peter Forsyth; Nina Paleologos; Denise D Correa; Nicole D Anderson; Dawn Caron; Andrew Zelenetz; Stephen D Nimer; Lisa M DeAngelis

doi:10.1200/JCO.2003.05.024

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Intensive Methotrexate and Cytarabine Followed by High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Newly Diagnosed Primary CNS Lymphoma: An Intent-to-Treat Analysis

Journal article

Peer reviewed

Intensive Methotrexate and Cytarabine Followed by High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Newly Diagnosed Primary CNS Lymphoma: An Intent-to-Treat Analysis

Lauren E Abrey, Craig H Moskowitz, Warren P Mason, Michael Crump, Douglas Stewart, Peter Forsyth, Nina Paleologos, Denise D Correa, Nicole D Anderson, Dawn Caron, …

Journal of clinical oncology, Vol.21(22), pp.4151-4156

2003-11-15

DOI: https://doi.org/10.1200/JCO.2003.05.024

PMID: 14615443

Abstract

Purpose: To assess the safety and efficacy of intensive methotrexate-based chemotherapy followed by high-dose chemotherapy (HDT) with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma (PCNSL). Patients and Methods: Twenty-eight patients received induction chemotherapy using high-dose systemic methotrexate (3.5 g/m2) and cytarabine (3 g/m2 daily for 2 days). Fourteen patients with chemosensitive disease evident on neuroimaging then received high-dose therapy using carmustine, etoposide, cytarabine, and melphalan with autologous stem-cell rescue. Results: The objective response rate to the induction-phase chemotherapy was 57%, and median overall survival is not yet assessable, with a median follow-up time of 28 months. The overall median event-free survival time is 5.6 months for all patients and 9.3 months for 14 patients who underwent transplantation. Six of these 14 patients (43%) remained disease-free at last follow-up. Treatment was well tolerated; there was one transplantation-related death. Prospective neuropsychologic evaluations have revealed no evidence of treatment-related neurotoxicity. Conclusion: This treatment approach is feasible in patients with newly diagnosed PCNSL without evidence of significant related neurotoxicity. Although the transplantation results are similar to those achieved in patients with aggressive or poor-prognosis systemic lymphoma, the low response rate to induction chemotherapy and the significant number of patients who experienced relapse soon after HDT suggest that more aggressive induction chemotherapy may be warranted.

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.130 Lymphomas; 1.130.1990 Primary Central Nervous System Lymphoma
Web Of Science research areas: Oncology
ESI research areas: Clinical Medicine

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Title: Intensive Methotrexate and Cytarabine Followed by High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Newly Diagnosed Primary CNS Lymphoma: An Intent-to-Treat Analysis
Creators: Lauren E Abrey - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Craig H Moskowitz - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Warren P Mason - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Michael Crump - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Douglas Stewart - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Peter Forsyth - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Nina Paleologos - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Denise D Correa - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Nicole D Anderson - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Dawn Caron - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Andrew Zelenetz - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Stephen D Nimer - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Lisa M DeAngelis - From the Departments of Neurology and Medicine and the Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, New York, NY; Princess Margaret Hospital, University of Toronto, Toronto; Tom Baker Cancer Center, University of Calgary, Calgary, Canada; and the Department of Neurology, Evanston Hospital, Northwestern University, Chicago, IL
Publication Details: Journal of clinical oncology, Vol.21(22), pp.4151-4156
Academic Unit: Leadership Department; Miller School of Medicine; Sylvester Comprehensive Cancer Center; UMMG Department of Medicine
Language: English
Resource Type: Journal article
PMID: 14615443
Record Identifier: 991031561390802976