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High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study).
Fritsch, K; Kasenda, B; Schorb, E; Hau, P; Bloehdorn, J; Möhle, R; Löw, S; Binder, M; Atta, J; Keller, U; Wolf, H-H; Krause, S W; Heß, G; Naumann, R; Sasse, S; Hirt, C; Lamprecht, M; Martens, U; Morgner, A; Panse, J; Frickhofen, N; Röth, A; Hader, C; Deckert, M; Fricker, H; Ihorst, G; Finke, J; Illerhaus, G.
Afiliación
  • Fritsch K; Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany.
  • Kasenda B; Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany.
  • Schorb E; Department of Medicine, Royal Marsden Hospital, London, UK.
  • Hau P; Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany.
  • Bloehdorn J; Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, Regensburg, Germany.
  • Möhle R; Department of Internal Medicine III, University of Ulm, Ulm, Germany.
  • Löw S; Department of Medicine II, Hematology and Oncology, University of Tübingen, Tübingen, Germany.
  • Binder M; Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
  • Atta J; Department of Internal Medicine II, Oncology/Hematology/Bone Marrow Transplantation with the Section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Keller U; Department of Internal Medicine II, Center of Internal Medicine, Johann Wolfgang Goethe-University, Frankfurt, Germany.
  • Wolf HH; III Medical Department, Technische Universität München, Munich, Germany.
  • Krause SW; Department of Haematology and Oncology, University Hospital Halle, Halle, Germany.
  • Heß G; Department of Internal Medicine 5, Universitätsklinik Erlangen, Erlangen, Germany.
  • Naumann R; Department of Hematology/Oncology, Johannes Gutenberg University, Mainz, Germany.
  • Sasse S; Department of Internal Medicine, Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany.
  • Hirt C; Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany.
  • Lamprecht M; Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
  • Martens U; Department of Internal Medicine II, University Hospital of Schleswig-Holstein, Kiel, Germany.
  • Morgner A; Department of Hematology/Oncology, Cancer Center Heilbronn-Franken, Heilbronn, Germany.
  • Panse J; Department of Internal Medicine III, Klinikum Chemnitz GmbH, Chemnitz, Germany.
  • Frickhofen N; Department of Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
  • Röth A; Department of Hematology and Oncology, HELIOS Dr-Horst-Schmidt-Kliniken, Wiesbaden, Germany.
  • Hader C; Department of Haematology, West German Cancer Centre, University Hospital Essen, Essen, Germany.
  • Deckert M; Department of Neuro-Radiology, University Hospital Freiburg, Freiburg, Germany.
  • Fricker H; Institute of Neuropathology, University Hospital of Cologne, Cologne, Germany.
  • Ihorst G; Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany.
  • Finke J; Clinical Trials Unit, Medical Centre - University of Freiburg, Freiburg, Germany.
  • Illerhaus G; Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany.
Leukemia ; 31(4): 846-852, 2017 04.
Article en En | MEDLINE | ID: mdl-27843136
To investigate immuno-chemotherapy for elderly immuno-competent patients (⩾65 years) with newly diagnosed primary central nervous system lymphoma, we conducted a multicentre single-arm trial. One cycle consisted of rituximab (375 mg/m2, days 1, 15, 29), high-dose methotrexate (3 g/m2 days 2, 16, 30), procarbazine (60 mg/m2 days 2-11) and lomustine (110 mg/m2, day 2)-R-MPL protocol. Owing to infectious complications, we omitted lomustine during the study and consecutive patients were treated with the R-MP protocol. Three cycles were scheduled and repeated on day 43. Subsequently, patients commenced 4 weekly maintenance treatment with procarbazine (100 mg for 5 days). Primary end point was complete remission (CR) after 3 cycles. We included 107 patients (69 treated with R-MPL and 38 with R-MP). In all, 38/107 patients achieved CR (35.5%) and 15 (14.0%) achieved partial remission. R-MP was associated with a lower CR rate (31.6%) compared with R-MPL (37.7%), but respective 2-year progression-free survival (All 37.3%; R-MP 34.9%; R-MPL 38.8%) and overall survival (All 47.0%; R-MP 47.7%; R-MPL 46.0%) rates were similar. R-MP was associated with less ⩾grade 3 toxicities compared with R-MPL (71.1% vs 87.0%). R-MP is more feasible while still associated with similar efficacy compared with R-MPL and warrants further improvement in future studies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Neoplasias del Sistema Nervioso Central / Linfoma Tipo de estudio: Clinical_trials / Diagnostic_studies / Guideline / Prognostic_studies Aspecto: Patient_preference Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Leukemia Asunto de la revista: HEMATOLOGIA / NEOPLASIAS Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Neoplasias del Sistema Nervioso Central / Linfoma Tipo de estudio: Clinical_trials / Diagnostic_studies / Guideline / Prognostic_studies Aspecto: Patient_preference Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Leukemia Asunto de la revista: HEMATOLOGIA / NEOPLASIAS Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido