Outcomes of Autologous Stem Cell Transplantation as a Consolidative Strategy for the Treatment of Primary and Isolated Secondary Central Nervous System Diffuse Large B Cell Lymphomas |
| |
| Institution: | 1. Hematology and Bone Marrow Transplantation Unit, Medicana International Ankara Hospital, Ankara, Turkey;2. Department of Hematology, Faculty of Medicine, Firat University, Elazig, Turkey;3. Department of Hematology, Faculty of Medicine, Ankara University, Ankara, Turkey;1. Immune Monitoring Core Laboratory, Levine Cancer Institute, Atrium Health, Charlotte, NC;2. Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC;3. Department of Hematologic Pathology, Atrium Health, Charlotte, NC;4. Department of Cancer Biostatistics, Levine Cancer Institute, Atrium Health, Charlotte, NC;5. Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, NY;1. Oslo Myeloma Center, Department of Haematology, Oslo University Hospital, Oslo, Norway;2. KG Jebsen Centre for B cell malignancies, University of Oslo, Oslo, Norway;3. Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain;4. Institut Gustave Roussy, Villejuif, France;5. Clínica Universidad de Navarra, CCUN, University of Navarra, Pamplona, Spain;6. Medical University of Lodz, Lodz, Poland;7. Skane University Hospital, Lund, Sweden and Sahlgrenska Academy, Gothenburg, Sweden;8. Genentech, Inc, South San Francisco, CA,;9. Syneos Health, Raleigh, Raleigh, NC,;10. Heidelberg University Hospital, Department of Medicine V, Heidelberg, Germany;1. Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA;2. Medical College of Wisconsin, Milwaukee, WI;3. City of Hope Comprehensive Cancer Center, Duarte, CA;4. Sarah Cannon Research Institute, Nashville, TN;5. Memorial Sloan Cancer Center, New York, NY;6. Janssen Research & Development, Raritan, NJ;7. Janssen Research & Development, Beerse, Belgium;8. Janssen Global Services, Raritan, NJ;9. Legend Biotech USA, Piscataway, NJ;10. RTI Health Solutions, Manchester, UK;11. Myeloma Patients Europe, Brussels, Belgium;12. University of Chicago, Chicago, IL;13. Mount Sinai Medical Center, New York, NY;1. Memorial Sloan Kettering Cancer Center, New York, NY;2. Eli Lilly and Company, Indianapolis, IN;3. Loxo@Lilly, Indianapolis, IN;1. Department of Hematology, Shanghai Fourth People''s Hospital, School of Medicine, Tongji University, Shanghai, China;2. Department of Hematology, Changzheng Hospital, Shanghai, China;3. The First Hospital of Jilin University, Jilin, China;4. Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian, China;5. State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China;6. Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin''s Clinical Research Center for Cancer, Tianjin, China;7. The First Affiliated Hospital of Soochow University, Suzhou, China;8. The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanzing, China;9. The First Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China;10. Peking University First Hospital, Beijing, China;11. Department of Hematology, Zhongda Hospital Southeast University, Nanzing ,, China;12. Department of Hematology, West China Hospital Sichuan University, Chengdu, China;13. Janssen Research & Development, LLC, Spring House, Lower Gwynedd Township, PA,;14. Janssen Research & Development, LLC, Beijing, China;15. Janssen Research & Development, LLC, Shanghai, China;16. Peking University People''s Hospital, National Clinical Research Center for Hematologic Disease, Beijing, China;17. Collaborative Innovation Center of Hematology, Soochow, China |
| |
| Abstract: | IntroductionStandard consolidation for primary diffuse large B cell lymphoma (DLBCL) of the central nervous system (CNS) (PCNSL) is not established. This single center, retrospective observational study aims to define the outcomes of consolidative high dose chemotherapy and autologous stem cell transplantation (HDC/ASCT) in patients with PCNSL and isolated secondary CNS DLBCL (SCNSL) and evaluate the prognostic factors.Patients and MethodsAll consecutive patients performed an HDC/ASCT for PCNSL or isolated SCNSLs between October 2012 and February 2022 were identified. Primary endpoints were progression-free survival (PFS) and overall survival (OS).ResultsAmong 35 patients included, 28 had PCNSL and 7 had isolated SCNSL. Median age was 51 (16-78). Males constituted 48.6%. Median follow-up after HDC/ASCT was 42.0 months. MATRIX (51.4%) and TEAM (80.0%) were the most frequent regimens of induction and conditioning, respectively. OS and PFS 1- and 2-year after HDC/ASCT were 68.0%, 57.0%, 58.0%, 48.0%, respectively. Increasing age, poor performance and comorbidities were associated with lower OS and PFS and higher non-relapse mortality (NRM). Complete response (CR) 1 at HDC/ACST was independently associated with higher OS and PFS hazard ratio (HR): 4.67 and 6.99, respectively].ConclusionIn patients < 60 years consolidative HDC/ASCT yields promising OS and PFS. Patients ≥ 60 years may less likely benefit from consolidative HDC/ASCT and should be studied further in trials of novel agents, lower doses of consolidative radiotherapy and dose-adjusted conditioning regimens. Not only age, but also comorbidities, clinical performance and response to induction correlate with outcomes. Patients with isolated SCNSL may achieve similar outcomes. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
