Intensive chemotherapy followed by autologous stem cell transplantation in primary central nervous system lymphomas (PCNSLs). Therapeutic outcomes in real life-experience of the French network - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Bone Marrow Transplantation Année : 2022

Intensive chemotherapy followed by autologous stem cell transplantation in primary central nervous system lymphomas (PCNSLs). Therapeutic outcomes in real life-experience of the French network

1 Service d'Hématologie [CHRU Nancy]
2 ICM - Institut du Cerveau = Paris Brain Institute
3 IGR - Institut Gustave Roussy
4 SBE - Service de biostatistique et d'épidémiologie
5 CHU Pitié-Salpêtrière [AP-HP]
6 Département d'hématologie, Institut Curie, Site Saint-Cloud
7 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
8 CHU Caen
9 Institut Bergonié [Bordeaux]
10 CHU Bordeaux
11 Service de Neurologie [Hôpitaux Civils de Colmar]
12 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
13 Institut de Cancérologie Lucien Neuwirth
14 MICMAC - Microenvironment, Cell Differentiation, Immunology and Cancer
15 MOBIDIC - Microenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer
16 CHU Amiens-Picardie
17 HEMATIM - HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666
18 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
19 INP - Institut de neurophysiopathologie
20 TIMONE - Hôpital de la Timone [CHU - APHM]
21 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
22 IPC - Institut Paoli-Calmettes
23 Service d’Hématologie Biologique [CHU Clermont-Ferrand]
24 Hôpital Bretonneau
25 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
26 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
27 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
28 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
29 CIC 1402 - CIC Poitiers – Centre d'investigation clinique de Poitiers
30 Hôpital Dupuytren [CHU Limoges]
31 Centre Hospitalier Saint Jean de Perpignan
32 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
33 Hôpital Cochin [AP-HP]
34 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
35 ICM - Institut régional de Cancérologie de Montpellier
36 AP-HP - Hopital Saint-Louis [AP-HP]
37 OncokappaB (URP_7324) - NF-kappaB, Différenciation et Cancer
38 GPMCND - Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques
39 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
40 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
41 Département d'Oncologie Chirurgicale [Institut Curie]
42 LITO - Laboratoire d'Imagerie Translationnelle en Oncologie
43 Hôpital Beaujon [AP-HP]
44 Hôpital Necker - Enfants Malades [AP-HP]
45 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
46 BIGS - Biology, genetics and statistics
47 IECL - Institut Élie Cartan de Lorraine
48 Hôpital de Mercy
49 CHR Metz-Thionville - Centre hospitalier régional Metz-Thionville
50 Hôpital Ambroise Paré [AP-HP]
51 NeuroDiderot (UMR_S_1141 / U1141) - Maladies neurodéveloppementales et neurovasculaires
52 CRAN - Centre de Recherche en Automatique de Nancy
53 ICSC - Institut Curie - Saint Cloud
54 U932 - Immunité et cancer
Gandhi Damaj
  • Fonction : Auteur
Krimo Bouabdallah
  • Fonction : Auteur

Résumé

We analysed the therapeutic outcomes of all consecutive patients with primary central nervous system lymphoma (PCNSL) registered in the prospective French database for PCNSL and treated with intensive chemotherapy (IC) followed by autologous stem cell transplantation (IC-ASCT) between 2011 and November 2019 (271 patients recruited, 266 analysed). In addition, treatment-related complications of thiotepa-based IC-ASCT were analysed from the source files of 85 patients from 3 centers. Patients had received IC-ASCT either in first-line treatment (n\,=\,147) or at relapse (n\,=\,119). The median age at IC-ASCT was 57 years (range: 22-74). IC consisted of thiotepa-BCNU (n\,=\,64), thiotepa-busulfan (n\,=\,24), BCNU-etoposide-cytarabine-melphalan (BEAM, n\,=\,36) and thiotepa-busulfan-cyclophosphamide (n\,=\,142). In multivariate analysis, BEAM and ASCT beyond the first relapse were adverse prognostic factors for relapse risk. The risk of treatment-related mortality was higher for ASCT performed beyond the first relapse and seemed higher for thiotepa-busulfan-cyclophosphamide. Thiotepa-BCNU tends to result in a higher relapse rate than thiotepa-busulfan-cyclophosphamide and thiotepa-busulfan. This study confirms the role of IC-ASCT in first-line treatment and at first-relapse PCNSL (5-year overall survival rates of 80 and 50%, respectively). The benefit/risk ratio of thiotepa-busulfan/thiotepa-busulfan-cyclophosphamide-ASCT could be improved by considering ASCT earlier in the course of the disease and dose adjustment of the IC.
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Dates et versions

hal-03703797 , version 1 (24-06-2022)

Identifiants

Citer

Laurence Schenone, Caroline Houillier, Marie Laure Tanguy, Sylvain Choquet, Kossi Agbetiafa, et al.. Intensive chemotherapy followed by autologous stem cell transplantation in primary central nervous system lymphomas (PCNSLs). Therapeutic outcomes in real life-experience of the French network. Bone Marrow Transplantation, 2022, 57 (6), pp.966-974. ⟨10.1038/s41409-022-01648-z⟩. ⟨hal-03703797⟩
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