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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

Laurence Schenone Caroline Houillier 1 Marie Laure Tanguy 2 Sylvain Choquet 3 Kossi Agbetiafa Hervé Ghesquières 4 Gandhi Damaj 5 Anna Schmitt Krimo Bouabdallah 6 Guido Ahle 7 Remy Gressin 8 Jérôme Cornillon 9 Roch Houot 10, 11 Jean-Pierre Marolleau 12, 13 Luc-Matthieu Fornecker 14 Olivier Chinot 15, 16 Frédéric Peyrade 17 Reda Bouabdallah 18 Cécile Moluçon-Chabrot 19 Emmanuel Gyan 20, 21 Adrien Chauchet 22 Olivier Casasnovas 23 Lucie Oberic 24 Vincent Delwail 25 Julie Abraham 26 Virginie Roland 27 Agathe Waultier-Rascalou 28 Lise Willems 29 Franck Morschhauser 30 Michel Fabbro 31 Renata Ursu 32 Catherine Thieblemont 32, 33 Fabrice Jardin 34, 35 Adrian Tempescul 36 Denis Malaise 37, 38 Valérie Touitou 39, 40 Lucia Nichelli 41 Magali Le Garff-Tavernier 3 Aurélie Plessier 42 Philippe Bourget 43 Caroline Bonmati 44 Sophie Wantz-Mézières 45, 46 Quentin Giordan Véronique Dorvaux 47 Cyril Charron 48 Waliyde Jabeur 49 Khê Hoang-Xuan 1, 50 Luc Taillandier 51, 44 Carole Soussain 2, 52 
45 BIGS - Biology, genetics and statistics
Inria Nancy - Grand Est, IECL - Institut Élie Cartan de Lorraine
Abstract : 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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https://hal-u-picardie.archives-ouvertes.fr/hal-03703797
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Soumis le : vendredi 24 juin 2022 - 12:02:20
Dernière modification le : vendredi 5 août 2022 - 12:02:19

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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, Nature Publishing Group, 2022, 57 (6), pp.966-974. ⟨10.1038/s41409-022-01648-z⟩. ⟨hal-03703797⟩

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