Background: Aggressive non-Hodgkin lymphomas with secondary central nervous system (CNS) involvement bear a dismal prognosis. Optimal treatment remains so far unclear, and effective treatment options remain an unmet clinical need. Remission rates are in general low, resulting in rapid relapses and palliative care in the majority of patients. High-intensity treatment combining effective CNS-directed chemoimmunotherapy with autologous stem cell transplantation was shown in a recent phase 2 trial to induce durable remissions. Here, we report the outcome of the first real-world patient cohort treated according to the published protocol. Methods: We retrospectively identified 17 HIV-negative lymphoma patients with secondary CNS involvement, either at first diagnosis or at relapse of lymphoma, treated according to the study protocol published by Ferreri et al. [J Clin Oncol. 2015] at two university medical centers in Germany. Treatment consisted of four cycles of chemoimmunotherapy with a consolidating autologous stem cell transplantation. Adverse events and overall outcome were assessed. Results: Five patients had CNS involvement at first diagnosis and 12 patients at relapse of lymphoma. A complete response was achieved in 9 patients. Median survival was 11 months. Five patients died of septic complications and 4 patients succumbed to progression or relapse of disease. Conclusions: The outcome of our real-world cohort emphasizes the possible toxic character of the treatment protocol by Ferreri et al. [J Clin Oncol. 2015]. Further improvement in treatment regimens is still an unmet need.
Oncol Res Treat

中文翻译：

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使用高强度化学免疫疗法和自体干细胞移植治疗继发性中枢神经系统淋巴瘤的真实世界患者队列的结果

背景：继发性中枢神经系统 (CNS) 受累的侵袭性非霍奇金淋巴瘤预后不佳。迄今为止，最佳治疗方案仍不清楚，有效的治疗方案仍然是未满足的临床需求。缓解率一般较低，导致大多数患者快速复发和姑息治疗。最近的一项 2 期试验显示，将有效的 CNS 定向化学免疫疗法与自体干细胞移植相结合的高强度治疗可诱导持久缓解。在这里，我们报告了根据已发布的协议治疗的第一个真实世界患者队列的结果。方法：我们回顾性地确定了 17 名 HIV 阴性淋巴瘤患者继发中枢神经系统受累，无论是在首次诊断时还是在淋巴瘤复发时，根据 Ferreri 等人发表的研究方案进行治疗。[J 临床肿瘤学。2015] 在德国的两个大学医学中心。治疗包括四个周期的化学免疫疗法和巩固的自体干细胞移植。评估了不良事件和总体结果。结果： 5 名患者在首次诊断时有 CNS 受累，12 名患者在淋巴瘤复发时受累。9 名患者获得完全缓解。中位生存期为 11 个月。5 名患者死于脓毒症并发症，4 名患者死于疾病进展或复发。结论：我们真实世界队列的结果强调了 Ferreri 等人的治疗方案可能存在的毒性特征。[J 临床肿瘤学。2015]。治疗方案的进一步改进仍然是一个未满足的需求。
肿瘤资源治疗