Research Papers:

Treatment of newly diagnosed B-cell origin primary CNS lymphoma with systemic R-IDARAM chemotherapy and intrathecal immunochemotherapy

Liren Qian _, Chunhui Zhou, Jianliang Shen, Jian Cen and Wenjie Yin

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Oncotarget. 2016; 7:25783-25790. https://doi.org/10.18632/oncotarget.8370

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Liren Qian1, Chunhui Zhou2, Jianliang Shen1, Jian Cen1, Wenjie Yin1

1Department of Hematology, Navy General Hospital, Beijing, PR China

2Department of Neurosurgery, Navy General Hospital, Beijing, PR China

Correspondence to:

Liren Qian, e-mail: [email protected]

Keywords: R-IDARAM, primary CNS lymphoma, diffuse large B-cell lymphoma, rituximab, immunochemotherapy

Received: January 25, 2016     Accepted: March 14, 2016     Published: March 25, 2016


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%).

Patients and 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.

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