Details

Autor(en) / Beteiligte

• Sterling, Cole H.
• Tsai, Hua-Ling
• Holdhoff, Matthias
• Bolaños-Meade, Javier
• Luznik, Leo
• Fuchs, Ephraim J.
• Huff, Carol Ann
• Gocke, Christian B.
• Ali, Syed Abbas
• Borrello, Ivan M.
• Varadhan, Ravi
• Jones, Richard J.
• Gladstone, Douglas E.
• Ambinder, Richard F.
• Wagner-Johnston, Nina
• Swinnen, Lode J.
• Imus, Philip H.

Titel

Allogeneic Blood or Marrow Transplantation with Nonmyeloablative Conditioning and High-Dose Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis for Secondary Central Nervous System Lymphoma

Ist Teil von

• Transplantation and cellular therapy, 2021-10, Vol.27 (10), p.863.e1-863.e5

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •We reviewed outcomes in 20 patients with secondary central nervous system (CNS) lymphoma undergoing allogeneic blood or marrow transplantation.•All patients received nonmyeloablative conditioning and post-transplantation cyclophosphamide.•Prolonged disease-free survival was achieved in ∼50% of patients.•Myeloablative conditioning and CNS radiotherapy were not required for remission. Secondary central nervous system (CNS) lymphoma is a rare and often fatal complication of non-Hodgkin lymphoma (NHL). Treatment options include radiation therapy, high-dose systemic chemotherapy, intrathecal chemotherapy, and high-dose chemotherapy with autologous stem cell rescue, but outcomes remain poor. Allogeneic blood or marrow transplantation (alloBMT) is widely used in patients with relapsed/refractory systemic NHL. We sought to understand whether a graft-versus-lymphoma effect could maintain remission in CNS disease. We reviewed outcomes in 20 consecutive patients with secondary CNS lymphoma who underwent alloBMT with nonmyeloablative conditioning using fludarabine, cyclophosphamide, and 200 cGy total body irradiation. For graft-versus-host disease prophylaxis, all patients received post-transplantation cyclophosphamide, mycophenolate mofetil, and a calcineurin inhibitor. With a median follow up of 4.1 years, the median overall survival for the entire cohort was not reached. Median progression-free survival was 3.8 years (95% confidence interval [CI], 5.3 months to not reached). The cumulative incidence of relapse was 25% (95% CI, 5% to 45%), and nonrelapse mortality was 30% (95% CI, 5% to 54%) at 4 years. Of the 5 patients who relapsed, 2 were CNS only, 1 was systemic only, and 2 were combined CNS/systemic. The use of alloBMT in CNS lymphoma merits further investigation.