Rituximab with high-dose methotrexate in primary central nervous system lymphoma

被引:51
|
作者
Kansara, Roopesh [1 ,2 ]
Shenkier, Tamara N. [1 ,2 ]
Connors, Joseph M. [1 ,2 ]
Sehn, Laurie H. [1 ,2 ]
Savage, Kerry J. [1 ,2 ]
Gerrie, Alina S. [1 ,2 ,3 ]
Villa, Diego [1 ,2 ]
机构
[1] British Columbia Canc Agcy, Ctr Lymphoid Canc, Vancouver, BC V5Z 4E6, Canada
[2] British Columbia Canc Agcy, Dept Med Oncol, Vancouver, BC V5Z 4E6, Canada
[3] Leukemia Bone Marrow Transplantat Program BC, Vancouver, BC, Canada
关键词
PRIMARY CNS LYMPHOMA; WHOLE-BRAIN RADIOTHERAPY; B-CELL LYMPHOMA; DEFERRED RADIOTHERAPY; INTRAOCULAR LYMPHOMA; DES LYMPHOMES; FOLLOW-UP; PHASE-II; CHEMOTHERAPY; TRIAL;
D O I
10.1002/ajh.24204
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The addition of rituximab (R) to chemotherapy improves outcomes in patients with systemic B-cell non-Hodgkin lymphomas, but the impact in patients with primary central nervous system lymphoma (PCNSL) receiving high-dose methotrexate (HDMTX) is unknown. Patients diagnosed with PCNSL at the British Columbia Cancer Agency (BCCA) between 2000 and 2013 were treated with >= 1 cycle of HDMTX 8 g/m(2) every 2 weeks, to best response or 10 cycles. After 2006, rituximab 375 mg/m(2) was given every 2 weeks with HDMTX for a total of 4 doses. 49 (66%) patients received HDMTX alone and 25 (34%) HDMTX+R, with a median of 5 (range 1-10) HDMTX cycles, and no difference between groups. The median follow-up was 5 years: 8.8 years (range 3.15-13.5 years) HDMTX and 1.9 years (range 0.5-7 years) HDMTX+R. The 5-year PFS was 17%, with no difference between groups (HR: 0.75, 95% CI: 0.41-1.35; P=0.33). The 5-year OS was 38%, with no difference between the groups OS (HR: 0.73, 95% CI: 0.35-1.52; P=0.39). In this retrospective study comparing two subgroups of patients treated in different eras, the addition of R to HDMTX did not appear to improve outcomes in PCNSL, possibly consistent with its known poor CNS penetration. It is possible that with a larger sample size, longer follow-up, or different rituximab dosing/schedule, the addition of rituximab may lead to a statistically significant improvement in outcomes. Prospective randomized trials currently in progress will more definitively estimate the impact of the addition of rituximab to HDMTX-based chemotherapy for PCNSL. (C) 2015 Wiley Periodicals, Inc.
引用
收藏
页码:1149 / 1154
页数:6
相关论文
共 50 条
  • [1] Primary central nervous system lymphoma treated with high-dose methotrexate and rituximab: Preliminary results in Vietnam
    Hoang, G. H. Nguyen
    Nguyen, P. T. B.
    Nguyen, H. T. N.
    Do, K. H.
    [J]. ANNALS OF ONCOLOGY, 2019, 30
  • [2] Ibrutinib in Combination with Rituximab and High-Dose Methotrexate in Newly Diagnosed Primary Central Nervous System Lymphoma Patients
    Guo, Yixian
    Lan, Xiaoxi
    Chang, Xiaoli
    Wang, Guoxiang
    Zou, Dongmei
    Su, Li
    Sun, Wanling
    [J]. BLOOD, 2021, 138
  • [3] Primary central nervous system lymphoma treated with high-dose methotrexate and rituximab: A single-institution experience
    Ly, K. Ina
    Crew, Laura L.
    Graham, Carrie A.
    Mrugala, Maciej M.
    [J]. ONCOLOGY LETTERS, 2016, 11 (05) : 3471 - 3476
  • [4] High-dose methotrexate combined with rituximab improves the survival rate of patients with primary central nervous system lymphoma
    Ma, Jing
    Ma, Xianjun
    [J]. JOURNAL OF BUON, 2021, 26 (02): : 366 - 372
  • [5] High-dose methotrexate dosing strategy in primary central nervous system lymphoma
    Wang, Alexander
    Cirrone, Frank
    De los Reyes, Francis Andrew
    Papadopoulos, John
    Saint Fleur-Lominy, Shella
    Xiang, Elaine
    [J]. LEUKEMIA & LYMPHOMA, 2022, 63 (06) : 1348 - 1355
  • [6] Hepatotoxicity from high-dose methotrexate in primary central nervous system lymphoma
    Zhang, Joy C.
    Stotts, Matthew J.
    Horton, Bethany
    Schiff, David
    [J]. NEURO-ONCOLOGY PRACTICE, 2023, 10 (03) : 291 - 300
  • [7] HEPATOTOXICITY FROM HIGH-DOSE METHOTREXATE IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA
    Zhang, Joy C.
    Horton, Bethany J.
    Stotts, Matthew J.
    Schiff, David
    [J]. GASTROENTEROLOGY, 2022, 162 (07) : S1284 - S1285
  • [8] HIGH-DOSE METHOTREXATE, HIGH-DOSE CYTARABINE AND TEMOZOLOMIDE FOR THE TREATMENT OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA
    Salamoon, M.
    Hussein, T.
    Kenj, M.
    [J]. HAEMATOLOGICA, 2013, 98 : 355 - 355
  • [9] White matter changes in primary central nervous system lymphoma patients treated with high-dose methotrexate with or without rituximab
    Estephan, Fayez
    Ye, Xiaobu
    Grossman, Stuart A.
    Lin, Doris D.
    Holdhoff, Matthias
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (15)
  • [10] White matter changes in primary central nervous system lymphoma patients treated with high-dose methotrexate with or without rituximab
    Fayez Estephan
    Xiaobu Ye
    Omar Dzaye
    Nina Wagner-Johnston
    Lode Swinnen
    Douglas E. Gladstone
    Rich Ambinder
    David Olayinka Kamson
    Sebastian Lambrecht
    Stuart A. Grossman
    Doris D. M. Lin
    Matthias Holdhoff
    [J]. Journal of Neuro-Oncology, 2019, 145 : 461 - 466