Clinical outcomes of patients with newly diagnosed primary central nervous system lymphoma are comparable on treatment with high-dose methotrexate plus temozolomide and with high-dose methotrexate plus cytarabine: a single-institution experience

Leuk Lymphoma. 2014 Nov;55(11):2497-501. doi: 10.3109/10428194.2014.889823. Epub 2014 Mar 10.

Abstract

The role of temozolomide in untreated PCNSL patients has not yet been clearly defined. The purpose of this study was to compare the efficacy and toxicity of MT and MC chemotherapy in this population. A total of 41 consecutive patients were enrolled from March 2001 to July 2011. The ORR and CRR for MT vs. MC were 70% vs. 61.9% and 45% vs. 38.1% on ITT basis, (p = NS); 73.7% vs. 68.4% and 47.4% vs. 42.1% on PP basis, respectively (p = NS). Grade 3-4 hematological toxicities were more common in MC than in MT group (85.7% vs. 15%, p = 0.0001). One treatment-related death was observed in each group. The 5-year PFS and OS of MT (36% and 62.2%) were comparable to MC (32.6% and 46.7%), (p = NS). In summary, our preliminary results suggest that MT combination may be a simplified and effective regimen comparable to MC for newly diagnosed PCNSL.

Keywords: Chemotherapy; cytarabine; high-dose methotrexate; primary CNS lymphoma; temozolomide.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Central Nervous System Neoplasms / drug therapy*
  • Central Nervous System Neoplasms / pathology
  • Cytarabine / administration & dosage
  • Cytarabine / adverse effects
  • Dacarbazine / administration & dosage
  • Dacarbazine / adverse effects
  • Dacarbazine / analogs & derivatives
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Lymphoma / drug therapy*
  • Lymphoma / pathology
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Middle Aged
  • Neutropenia / chemically induced
  • Remission Induction
  • Temozolomide
  • Thrombocytopenia / chemically induced
  • Treatment Outcome
  • Young Adult

Substances

  • Cytarabine
  • Dacarbazine
  • Temozolomide
  • Methotrexate