High-Dose Chemotherapy with Autologous Stem Cell Transplantation in Primary Central Nervous System Lymphoma: Data From the Japan Society for Hematopoietic Cell Transplantation Registry

for the Adult Lymphoma Working Group of the Japan Society for Hematopoietic Cell Transplantation

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

High-dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT) has been shown to improve the prognosis of patients with central nervous system (CNS) lymphoma. We queried the Japan Society for Hematopoietic Cell Transplantation Registry for 2006 to 2015 to analyze the outcomes of 102 patients with primary CNS lymphoma (PCNSL) who underwent first HDT/ASCT. The median patient age was 54 years (range, 20 to 74 years), and 65 patients were treated in an upfront setting. With a median duration of follow-up of 44 months, the 5-year overall survival (OS) and progession-free survival (PFS) were 54.9% and 38.4%, respectively. There were no significant differences in OS and PFS between upfront and salvage HDT/ASCT. Because thiotepa, a key agent in HDT/ASCT for PCNSL, has been unavailable since 2011 in Japan, the HDT regimens used were not uniform. Thiotepa-containing HDT was received by 16 out of 32 patients before 2010, but by only 2 of 70 patients after 2011. Thiotepa-containing HDT was associated with better PFS (P =.019), lower relapse (P =.042), and a trend toward a survival benefit. In multivariate analysis, noncomplete remission at HDT/ASCT was an independent predictor for OS (hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.25 to 4.58; P =.008) and thiotepa-containing HDT remained significant for PFS (HR,.42; 95% CI,.19 to.95; P =.038). These results confirm the activity of thiotepa-containing regimens.

Original languageEnglish
JournalBiology of Blood and Marrow Transplantation
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Cell Transplantation
Stem Cell Transplantation
Registries
Lymphoma
Japan
Central Nervous System
Thiotepa
Drug Therapy
Survival
Confidence Intervals
Multivariate Analysis
Recurrence

Keywords

  • High-dose chemotherapy/autologous stem cell transplantation
  • Primary central nervous system lymphoma
  • Thiotepa

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

High-Dose Chemotherapy with Autologous Stem Cell Transplantation in Primary Central Nervous System Lymphoma : Data From the Japan Society for Hematopoietic Cell Transplantation Registry. / for the Adult Lymphoma Working Group of the Japan Society for Hematopoietic Cell Transplantation.

In: Biology of Blood and Marrow Transplantation, 01.01.2019.

Research output: Contribution to journalArticle

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title = "High-Dose Chemotherapy with Autologous Stem Cell Transplantation in Primary Central Nervous System Lymphoma: Data From the Japan Society for Hematopoietic Cell Transplantation Registry",
abstract = "High-dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT) has been shown to improve the prognosis of patients with central nervous system (CNS) lymphoma. We queried the Japan Society for Hematopoietic Cell Transplantation Registry for 2006 to 2015 to analyze the outcomes of 102 patients with primary CNS lymphoma (PCNSL) who underwent first HDT/ASCT. The median patient age was 54 years (range, 20 to 74 years), and 65 patients were treated in an upfront setting. With a median duration of follow-up of 44 months, the 5-year overall survival (OS) and progession-free survival (PFS) were 54.9{\%} and 38.4{\%}, respectively. There were no significant differences in OS and PFS between upfront and salvage HDT/ASCT. Because thiotepa, a key agent in HDT/ASCT for PCNSL, has been unavailable since 2011 in Japan, the HDT regimens used were not uniform. Thiotepa-containing HDT was received by 16 out of 32 patients before 2010, but by only 2 of 70 patients after 2011. Thiotepa-containing HDT was associated with better PFS (P =.019), lower relapse (P =.042), and a trend toward a survival benefit. In multivariate analysis, noncomplete remission at HDT/ASCT was an independent predictor for OS (hazard ratio [HR], 2.40; 95{\%} confidence interval [CI], 1.25 to 4.58; P =.008) and thiotepa-containing HDT remained significant for PFS (HR,.42; 95{\%} CI,.19 to.95; P =.038). These results confirm the activity of thiotepa-containing regimens.",
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AU - Kondo, Eisei

AU - Ikeda, Takashi

AU - Izutsu, Koji

AU - Chihara, Dai

AU - Shimizu-Koresawa, Risa

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AU - Kondo, Tadakazu

AU - Kubo, Kohmei

AU - Kato, Yuichi

AU - Akasaka, Takashi

AU - Fukuda, Takahiro

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