Consolidative high dose chemotherapy and autologous stem cell transplant for patients with primary central nervous system lymphoma using thiotepa, busulfan, and cyclophosphamide conditioning regimen.

Natalizumab is used as a second-line treatment for multiple sclerosis (MS). Some reports have linked natalizumab to primary central nervous system lymphoma (PCNSL), although few have described its management. A 45-year-old woman with Balo’s Concentric Sclerosis presented dizziness, vertigo accompanied by dysarthria, weakness on the left side and blurred vision to the right eye after the fourth dose of natalizumab. Magnetic resonance imaging (MRI) and a brain biopsy confirmed the diagnosis of PCNSL. The patient received modified PCNSL chemotherapy (MATRix protocol) followed by high-dose chemotherapy (HDC) supported by an autologous hematopoietic stem cell transplant (ASCT) as a consolidation therapy. Thirty months later, she is still in complete remission of her PCNSL and MS. In this case, whole brain radiotherapy was excluded because it may be associated with an increased risk of neurotoxicity in MS. ASCT was preferred because it has been shown to prevent disability progression in less advanced MS stages. Our patient is the second to receive an ASCT in this context and this option of treatment should be the preferred if the patient is eligible.

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Consolidative Whole-Brain Radiation Therapy Versus Autologous Stem Cell Transplant for Primary Central Nervous System Lymphoma: A Large Dose of Perspective and Perhaps a Lower Dose of Radiation Are in Order

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2018.04.040 ◽

2018 ◽

Vol 102 (1) ◽

pp. 59-60 ◽

Cited By ~ 1

Author(s):

Joseph A. Bovi ◽

Christopher J. Schultz ◽

Minesh P. Mehta ◽

Benjamin W. Corn

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Radiation Therapy ◽

Stem Cell ◽

Stem Cell Transplant ◽

Central Nervous System Lymphoma ◽

Autologous Stem Cell Transplant ◽

Cell Transplant ◽

Whole Brain Radiation ◽

Brain Radiation

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Role of high-dose chemotherapy with autologous stem cell transplantation for primary central nervous system lymphoma: A systematic review.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.2562 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 2562-2562

Author(s):

Shaha Nabeel ◽

Zahoor Ahmed ◽

Arafat Ali Farooqui ◽

Zunairah Shah ◽

Aqsa Ashraf ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Stem Cell ◽

Primary Cns Lymphoma ◽

Central Nervous System Lymphoma ◽

Progression Free Survival ◽

High Dose Chemotherapy ◽

Cns Lymphoma ◽

High Dose ◽

Cell Transplant

2562 Background: High dose chemotherapy (HDCT) followed by autologous stem cell transplant (ASCT) has shown to overcome intrinsic chemo-resistance and improve disease control in Primary Central Nervous System Lymphoma (PCNSL). Our study reviews the treatment outcome in PCNSL with sequential HDCT and ASCT. Methods: 8/34 studies were finalized after systematic search of PubMed, Cochrane, and Clinicaltrials.gov for treatment of PCNSL with HDCT followed by ASCT. Results: 251/288 patients were evaluated. Mean age was 55.5 years. 227 underwent HDCT-ASCT. 174 were newly diagnosed (ND) and 77 had relapsed refractory (R/R) PCNSL. ND patients showed superior outcomes in terms of progression free survival and overall survival. Combinations of High dose Rituximab, Busulfan and Cyclophosphamide significantly improved survival outcomes in RR patients. Significant toxicities mainly included pancytopenias and opportunistic. Conclusions: Primary CNS lymphoma treated with HDCT followed by ASCT has shown promising outcomes and has set a benchmark for future studies. [Table: see text]

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