論文

査読有り 国際誌
2019年5月

High-Dose Chemotherapy with Autologous Stem Cell Transplantation in Primary Central Nervous System Lymphoma: Data From the Japan Society for Hematopoietic Cell Transplantation Registry.

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • Eisei Kondo
  • ,
  • Takashi Ikeda
  • ,
  • Koji Izutsu
  • ,
  • Dai Chihara
  • ,
  • Risa Shimizu-Koresawa
  • ,
  • Nobuharu Fujii
  • ,
  • Tomoyuki Sakai
  • ,
  • Tadakazu Kondo
  • ,
  • Kohmei Kubo
  • ,
  • Yuichi Kato
  • ,
  • Takashi Akasaka
  • ,
  • Takahiro Fukuda
  • ,
  • Tatsuo Ichinohe
  • ,
  • Yoshiko Atsuta
  • ,
  • Junji Suzumiya
  • ,
  • Ritsuro Suzuki

25
5
開始ページ
899
終了ページ
905
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.bbmt.2019.01.020
出版者・発行元
Elsevier {BV}

High-dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT) has been shown to improve the prognosis of patients with central nervous system (CNS) lymphoma. We queried the Japan Society for Hematopoietic Cell Transplantation Registry for 2006 to 2015 to analyze the outcomes of 102 patients with primary CNS lymphoma (PCNSL) who underwent first HDT/ASCT. The median patient age was 54 years (range, 20 to 74 years), and 65 patients were treated in an upfront setting. With a median duration of follow-up of 44 months, the 5-year overall survival (OS) and progession-free survival (PFS) were 54.9% and 38.4%, respectively. There were no significant differences in OS and PFS between upfront and salvage HDT/ASCT. Because thiotepa, a key agent in HDT/ASCT for PCNSL, has been unavailable since 2011 in Japan, the HDT regimens used were not uniform. Thiotepa-containing HDT was received by 16 out of 32 patients before 2010, but by only 2 of 70 patients after 2011. Thiotepa-containing HDT was associated with better PFS (P = .019), lower relapse (P = .042), and a trend toward a survival benefit. In multivariate analysis, noncomplete remission at HDT/ASCT was an independent predictor for OS (hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.25 to 4.58; P = .008) and thiotepa-containing HDT remained significant for PFS (HR, .42; 95% CI, .19 to .95; P = .038). These results confirm the activity of thiotepa-containing regimens.

リンク情報
DOI
https://doi.org/10.1016/j.bbmt.2019.01.020
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30664936
URL
http://orcid.org/0000-0003-0995-9405

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