Feasibility of BU, CY and etoposide (BUCYE), and auto-SCT in patients with newly diagnosed primary CNS lymphoma: a single-center experience

Bone Marrow Transplant. 2011 Jan;46(1):105-9. doi: 10.1038/bmt.2010.71. Epub 2010 Apr 12.

Abstract

We investigated the feasibility of i.v. BU, CY and etoposide (BUCYE), followed by auto-SCT (ASCT) in patients with newly diagnosed primary central nervous system lymphoma (PCNSL). The planned treatment consisted of induction chemotherapy with five cycles of high-dose MTX and two cycles of high-dose cytarabine followed by conditioning with BUCYE (BU 3.2 mg/m², day -7 to day -5; CY 50 mg/kg, day -3 to day -2 and etoposide 200 mg/m², twice a day, days -5 and -4) and then ASCT. Between May 2005 and November 2008, 11 consecutive PCNSL patients were treated. All patients completed the treatment as planned, with no cases of treatment-related death or veno-occlusive disease. After BUCYE and ASCT, 10 patients achieved complete response (CR) or unconfirmed CR (CRu). Two patients, one partial response and one CRu, received further whole-brain radiotherapy, with all achieving CR. At a median follow-up of 25.0 months (8.8-50.7 months), six patients had relapsed, with a median event-free interval of 15.0 months (95% confidence interval, 4.5-25.6 months). Median survival time was not reached yet with a 2-year survival rate of 88.9%. The current treatment was feasible with a favorable tolerance profile. However, further regimen optimization is necessary because of high relapse rate.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Busulfan / administration & dosage
  • Busulfan / adverse effects
  • Busulfan / therapeutic use*
  • Central Nervous System Neoplasms / drug therapy
  • Central Nervous System Neoplasms / radiotherapy
  • Central Nervous System Neoplasms / therapy*
  • Combined Modality Therapy / adverse effects
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Cyclophosphamide / therapeutic use*
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Etoposide / therapeutic use*
  • Feasibility Studies
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Lymphoma / drug therapy
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Recurrence
  • Remission Induction
  • Survival Analysis
  • Transplantation Conditioning / adverse effects
  • Transplantation Conditioning / methods
  • Transplantation, Autologous

Substances

  • Antineoplastic Agents
  • Etoposide
  • Cyclophosphamide
  • Busulfan