Abstract
Abstract 2719
The aim of this study was to evaluate treatment outcomes and prognostic factors of high-dose MVP (methotrexate, vincristine and procarbazine) chemotherapy and response adapted intensification therapy in primary central nervous system lymphoma (PCNSL). We evaluated the expression of Epstein-Barr virus (EBV)-encoded RNA in tissue and pretreatment EBV-DNA in whole blood. Forty patients with PCNSL who treated with high-dose MVP chemotherapy were retrospectively reviewed. Additional radiotherapy or autologous stem cell transplantation were performed for the patients who could not achieve complete response (CR) at interim response (Figure 1). The median age was 55 years. CR rate was 50.0% and objective response rate was 80.0%. Two-year overall survival (OS) was 59.8% and 2-year progression free survival (PFS) was 47.1%. Grade 3 or 4 neutropenia was seen in 19 of 40 (47.5%) patients and thrombocytopenia was developed in 13 (32.5%) patients. Treatment-related mortality was occurred in 4 patients. Delayed neurotoxicity was occurred in 4 patients. Poor performance status, elevated cerebrospinal fluid protein level and whole blood EBV-DNA positivity showed inferior OS (P=0.036, P=0.022, P=0.013, respectively, Figure 2). We detected whole blood EBV-DNA in 10 (29.4%) of 34 patients. It was related with poor OS and PFS in high risk patients according to International Extranodal Lymphoma Study Group scores (P=0.015, P=0.027, respectively). This study suggests that high-dose MVP chemotherapy without intrathecal chemotherapy and response adapted strategy may be an effective regimen for the newly diagnosed PCNSL. Whole blood EBV-DNA positivity could predict the inferior outcome in high-risk patients.
Treatment schemeHD-MVP high dose methotrexate, vincristine and procarbazine, CR complete response, CRu unconfirmed complete response, PR partial response, SD stable disease, PD progressive disease, Tx treatment, NE not evaluated, ASCT autologous hematopoietic stem cell transplantation, RT radiotherapy
Treatment schemeHD-MVP high dose methotrexate, vincristine and procarbazine, CR complete response, CRu unconfirmed complete response, PR partial response, SD stable disease, PD progressive disease, Tx treatment, NE not evaluated, ASCT autologous hematopoietic stem cell transplantation, RT radiotherapy
Overall survival and progression free survival according to EBV-DNA status in high risk patients. EBV Epstein-Barr virus
Overall survival and progression free survival according to EBV-DNA status in high risk patients. EBV Epstein-Barr virus
No relevant conflicts of interest to declare.
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