Oncotarget

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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Abstract

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

ABSTRACT

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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