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Title: | Excellent outcomes in older patients with primary CNS lymphoma treated with R-MPV/cytarabine without whole brain radiotherapy or autologous stem cell transplantation therapy. | Authors: | Paul E.;Quach H.;Bazargan A.;Ku M.;Tey A.;Shortt J. ;Opat S. ;Tam C.;Filshie R.;Gregory G.P.;Gilberston M.;Tatarczuch M. | Monash Health Department(s): | Haematology | Institution: | (Tatarczuch, Gilberston, Gregory, Tey, Shortt, Opat) Monash Haematology, Monash Health, Melbourne, Australia (Tatarczuch, Gilberston, Gregory, Shortt, Opat) School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia (Paul, Tam, Quach, Bazargan, Filshie, Ku) St. Vincent's Hospital, Melbourne, Australia (Paul, Tam, Quach, Bazargan, Ku) University of Melbourne, Melbourne, Australia | Issue Date: | 5-Feb-2021 | Copyright year: | 2021 | Publisher: | Taylor and Francis Ltd. | Place of publication: | United Kingdom | Publication information: | Leukemia and Lymphoma. 62 (1) (pp 112-117), 2021. Date of Publication: 2021. | Journal: | Leukemia and Lymphoma | Abstract: | Primary CNS lymphoma (PCNSL) in immunocompetent patients is a disease of older adults who are often unsuitable for the high dose therapy or experience substantial morbidity from whole brain radiotherapy. As therapeutic studies in older patients are limited, there is a need for real world data to guide patient care. Here we report a series of 38 consecutive immunocompetent patients with PCNSL treated with curative intent using R-MPV/Ara-C with omission of consolidative radiotherapy in older patients. Outcomes for patients aged < 60 years and > 60 years were similar with overall response rates of 100% vs 85%, (p =.30), 4-year PFS of 81% vs 82% (p =.92) and 4-year OS of 80% vs 77% (p =.52) respectively. This study supports the premise that older patients with PCNSL can be effectively treated with sequential and response-adapted methotrexate (MTX) dosing without the need for WBRT or autologous stem cell transplantation (ASCT).Copyright © 2020 Informa UK Limited, trading as Taylor & Francis Group. | DOI: | http://monash.idm.oclc.org/login?url= http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1080/10428194.2020.1821007 |
PubMed URL: | 32981406 [http://www.ncbi.nlm.nih.gov/pubmed/?term=32981406] | ISSN: | 1042-8194 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/27443 | Type: | Article | Subjects: | observational study oncological parameters overall response rate overall survival *primary central nervous system lymphoma/dt [Drug Therapy] *primary central nervous system lymphoma/rt [Radiotherapy] priority journal progression free survival retrospective study salvage therapy survival analysis survival rate treatment outcome treatment refusal treatment response whole brain radiotherapy corticosteroid *cytarabine/ae [Adverse Drug Reaction] *cytarabine/cb [Drug Combination] *cytarabine/dt [Drug Therapy] *cytarabine/to [Drug Toxicity] *cytarabine/pv [Special Situation for Pharmacovigilance] *cytarabine/tm [Unexpected Outcome of Drug Treatment] *methotrexate/ae [Adverse Drug Reaction] *methotrexate/cb [Drug Combination] *methotrexate/dt [Drug Therapy] *methotrexate/to [Drug Toxicity] *methotrexate/tl [Intrathecal Drug Administration] *methotrexate/pv [Special Situation for Pharmacovigilance] *methotrexate/tm [Unexpected Outcome of Drug Treatment] *procarbazine/ae [Adverse Drug Reaction] *procarbazine/cb [Drug Combination] *procarbazine/dt [Drug Therapy] *procarbazine/to [Drug Toxicity] *procarbazine/pv [Special Situation for Pharmacovigilance] *procarbazine/tm [Unexpected Outcome of Drug Treatment] *rituximab/ae [Adverse Drug Reaction] *rituximab/cb [Drug Combination] *rituximab/dt [Drug Therapy] *rituximab/to [Drug Toxicity] *rituximab/pv [Special Situation for Pharmacovigilance] *rituximab/tm [Unexpected Outcome of Drug Treatment] *vincristine/ae [Adverse Drug Reaction] *vincristine/cb [Drug Combination] *vincristine/dt [Drug Therapy] *vincristine/to [Drug Toxicity] *vincristine/pv [Special Situation for Pharmacovigilance] *vincristine/tm [Unexpected Outcome of Drug Treatment] complete response rate drug fatality/si [Side Effect] adult age aged article *cancer combination chemotherapy cancer patient *cancer prognosis cancer radiotherapy cancer regression cancer survival clinical article *clinical outcome cohort analysis consolidation chemotherapy controlled study drug dose reduction drug megadose female human immunocompetence male median survival time multiple cycle treatment neurotoxicity/si [Side Effect] consolidation chemotherapy controlled study drug dose reduction drug fatality / side effect drug megadose female human immunocompetence male median survival time multiple cycle treatment neurotoxicity / side effect observational study oncological parameters overall response rate overall survival *primary central nervous system lymphoma / *drug therapy / *radiotherapy priority journal progression free survival retrospective study salvage therapy survival analysis survival rate Article treatment refusal treatment response whole brain radiotherapy aged age adult treatment outcome *cancer combination chemotherapy cancer patient *cancer prognosis cancer radiotherapy cancer regression cancer survival clinical article *clinical outcome cohort analysis |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
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