Intravenous high-dose methotrexate based systemic therapy in the treatment of isolated primary vitreoretinal lymphoma: an LOC network study - Université de Rennes Accéder directement au contenu
Article Dans Une Revue American Journal of Hematology Année : 2021

Intravenous high-dose methotrexate based systemic therapy in the treatment of isolated primary vitreoretinal lymphoma: an LOC network study

1 CHU Pitié-Salpêtrière [AP-HP]
2 SU - Sorbonne Université
3 Institut Curie [Paris]
4 UPCité - Université Paris Cité
5 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
6 MATEIS - Matériaux, ingénierie et science [Villeurbanne]
7 Hôpital de la Croix-Rousse [CHU - HCL]
8 Institut Bergonié [Bordeaux]
9 BPH - Bordeaux population health
10 CHU de Bordeaux Pellegrin [Bordeaux]
11 CRO2 - Centre de Recherches en Oncologie biologique et Oncopharmacologie
12 Ophtalmologie [Hôpital de la Timone - APMH]
13 Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse
14 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
15 MICMAC - Microenvironment, Cell Differentiation, Immunology and Cancer
16 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
17 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
18 CHU Angers - Centre Hospitalier Universitaire d'Angers
19 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
20 Hôpital pasteur [Colmar]
21 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
22 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
23 CHU Amiens-Picardie
24 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
25 CHU Clermont-Ferrand
26 CHU Montpellier
27 CHU Nantes - Centre Hospitalier Universitaire de Nantes
28 Hôpital Cochin [AP-HP]
29 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
30 NeurATRIS - IHU-A-ICM - Institut de neurosciences translationnelles de Paris
31 U932 - Immunité et cancer
Hervé Ghesquières
  • Fonction : Auteur
  • PersonId : 758237
  • IdRef : 067203779
Priscille Ollé
  • Fonction : Auteur
Jean-Pierre Marolleau
  • Fonction : Auteur
  • PersonId : 887235
  • IdRef : 06981676X
Gandhi Damaj
  • Fonction : Auteur
Paul Franciane
  • Fonction : Auteur

Résumé

The treatment of primary vitreoretinal lymphoma (PVRL) remains controversial regarding the use of local, systemic, or combined treatments. The aim of this study was to analyze the efficacy and toxicity of intravenous high-dose methotrexate (IV HD-MTX) based systemic therapy in a uniformly treated population of PVRL patients. From a nationwide French database, we retrospectively selected 59 patients (median age: 70 years, median Karnofsky Performance Status: 90%) with isolated PVRL at diagnosis who received first-line treatment with HD-MTX between 2011-2018. 8/59 patients also received a local treatment. No deaths or premature discontinuations of MTX due to toxicity were reported. A complete response was obtained in 40/57 patients after chemotherapy. Before treatment, IL-10 was elevated in the aqueous humor (AH) or in the vitreous in 89% of patients. After treatment, AH IL-10 was undetectable in 87% of patients with a CR/uCR/PR and detectable in 92% of patients with PD/SD. After a median follow-up of 61 months, 41/59 (69%) patients had relapsed, including 29 isolated ocular relapses as the first relapse and a total of 22 brain relapses. The median overall survival, progression-free survival, ocular-free survival and brain-free survival were 75, 18, 29 and 73 months, respectively. IV HD-MTX based systemic therapy as a first-line treatment for isolated PVRL is feasible, with acceptable toxicity, even in an elderly population. This strategy seems efficient to prevent brain relapse with prolonged overall survival. However, the ocular relapse rate remains high. New approaches are needed to improve local control of this disease, and ocular assessment could be completed by monitoring AH IL-10.
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Dates et versions

hal-03228816 , version 1 (11-06-2021)

Identifiants

Citer

Marion Lam, Valérie Touitou, Sylvain Choquet, Nathalie Cassoux, Hervé Ghesquières, et al.. Intravenous high-dose methotrexate based systemic therapy in the treatment of isolated primary vitreoretinal lymphoma: an LOC network study. American Journal of Hematology, 2021, 96 (7), pp.823-833. ⟨10.1002/ajh.26199⟩. ⟨hal-03228816⟩
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