Results of the IELSG32 trial at a median follow-up of 88 months demonstrate that matrix followed by autologous transplant is associated with excellent survival and neurotolerability in patients with primary CNS lymphoma

التفاصيل البيبلوغرافية
العنوان: Results of the IELSG32 trial at a median follow-up of 88 months demonstrate that matrix followed by autologous transplant is associated with excellent survival and neurotolerability in patients with primary CNS lymphoma
المؤلفون: Calimeri, T., Cwynarski, K., Pulczynski, E., Fox, C. P., Schorb, E., Steffanoni, S., Foppoli, M., Celico, C., Falautano, M., Nonis, A., La Rosee, P., Binder, M., Fabbri, A., Ilariucci, F., Krampera, M., Roth, A., Hemmaway, C., Johnson, P. W., Linton, Kim M, Pukrop, T., Gorlov, J., Balzarotti, M., Hess, G., Keller, U., Stilgenbauer, S., Panse, J., Tucci, A., Orsucci, L., Pisani, F., Zanni, M., Krause, S. W., Schmoll, H. J., Hertenstein, B., Rummel, M., Smith, J., Thurner, L., Cabras, G., Pennese, E., Ponzoni, M., Deckert, M., Politi, L. S., Finke, J., Ferranti, A., Cozens, K., Burger, E., Ielmini, N., Cavalli, F., Zucca, E., Illerhaus, G., Ferreri, A. J. M.
المساهمون: Lymphoma Unit, Department of Onco-Hematology ,IRCCS SanRaffaele Scientific Institute ,Milan, Italy
سنة النشر: 2021
المجموعة: The Christie School of Oncology: Christie Research Publications Repository
الوصف: Introduction: The MATRix regimen (methotrexate, cytarabine, thiotepa, rituximab) significantly improved outcome of pts with primary CNS lymphoma (PCNSL) enrolled in the IELSG32 trial. At a median follow-up of 40 months, both whole-brain irradiation (WBRT) and autologous transplantation (ASCT) were safe and equally effective. However, sound assessment of OS, late complications, incidence of secondary tumors, and cognitive impairment requires longer follow-up. Herein, we report the results of IELSG32 trial at a median follow-up of 88 (IQR 77- 99) months. Methods: pts with untreated PCNSL (18-70 years) were randomly as signed to methotrexate-cytarabine (arm A), or arm A + rituximab (arm B), or arm B + thiotepa (MATRix; arm C). A second randomization assigned pts with responsive/stable disease after induction to WBRT (arm D) or BCNU-Thiotepa-conditioning ASCT (arm E). Treatment effect on cognitive functions and quality of life (QoL) were addressed by IPCG tests panel and EORTC-QLQ. Results: 219 pts were randomized (arm A 75; B 69; C 75). After induction, 167 had responsive/stable disease: 118 were assigned to WBRT (59) or ASCT (59) while 49 were excluded from 2nd randomization. Fifteen pts died of iatrogenic toxicity; 87 (40%) pts remain relapse-free (A 17; B 28; C 42), 14 of them died of unrelated causes (Table 1). Among 117 relapsing pts, 96 died of PCNSL, 7 of salvage therapy complications. Eight pts developed second cancers at 48-96 months from WBRT (5) or ASCT (3). Second tumors and deaths in relapse-free pts or during salvage were not significantly related to treatments (Table 1). Neuropsychological tests showed a significant impairment in attentiveness and executive functions in the WBRT arm, while transplanted pts had a significant improvement in these functions as well as memory and QoL. Pts treated with MATRix showed significantly better PFS (7-year: 20% arm A; 29% arm B; 52% arm C) and OS (7-year: 26% arm A; 37% arm B; 56% arm C). No significant differences were seen between the consolidation arms for ...
نوع الوثيقة: conference object
اللغة: unknown
Relation: Calimeri T, Cwynarski K, Pulczynski E, Fox CP, Schorb E, Steffanoni S, et al. RESULTS OF THE IELSG32 TRIAL AT A MEDIAN FOLLOW-UP OF 88 MONTHS DEMONSTRATE THAT MATRIX FOLLOWED BY AUTOLOGOUS TRANSPLANT IS ASSOCIATED WITH EXCELLENT SURVIVAL AND NEUROTOLERABILITY IN PATIENTS WITH PRIMARY CNS LYMPHOMA. Haematologica. 2021;106(10):33-.; http://hdl.handle.net/10541/624914; Haematologica
الاتاحة: http://hdl.handle.net/10541/624914
رقم الانضمام: edsbas.7B700D15
قاعدة البيانات: BASE