Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Outcomes
2.3. Procedures
2.4. Local Treatment of Intraocular Lymphoma
2.5. Side Effects
2.6. Response Assessment
2.7. Statistics
3. Results
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Chemotherapy Agent | Dose | Route | Day of Cycle |
---|---|---|---|
Rituximab | 375 mg/m2 | intravenous | 0 |
Methotrexate | 2500 mg/m2 | intra-arterial | 1–2 |
Carboplatin | 200 mg/m2 | intra-arterial | 1–2 |
Dexamethasone | 6 mg × 4–6 | peroral | 2–10 |
Cytarabine | 40 mg | intrathecal | 14 |
Cyclophosphamide | 330 mg/m2 | intravenous | 1–2 |
Etoposide | 200 mg/m2 | intravenous | 1–2 |
Sex | N (%) |
---|---|
Male | 12 (48) |
Female | 13 (52) |
Age at diagnosis | (mean + SD) |
Years | 61.3 ± 10.9 |
Performance status (WHO a) | N (%) |
0 | 4 (16) |
1 | 10 (40) |
2 | 5 (20) |
3 | 6 (24) |
MSKCC b risk group | N (%) |
0 (age < 50 years) | 4 (16) |
1 (age ≥ 50 years and KPS c ≥ 70%) | 11 (44) |
2 (age ≥ 50 years and KPS c < 70%) | 10 (40) |
Deep brain structure involvement | N (%) |
Yes | 24 (96) |
No | 1 (4) |
Eye involvement | N (%) |
No | 22 (88) |
Yes | 3 (12) |
Spinal involvement | N (%) |
No | 23 (92) |
Yes | 1 (4) |
N/A | 1 (4) |
Response | After MATRix Regimen | After BBBD Treatment | At Restaging |
---|---|---|---|
Complete response, N (%) | 0 (0) | 19 (76) | 22 (88) |
Partial response, N (%) | 23 (92) | 5 (20) | 2 (8) |
Stable disease, N (%) | 0 (0) | 0 (0) | 0 (0) |
Progressive disease, N (%) | 1 (4) | 0 (0) | 1 (4) |
Not evaluable, N (%) | 1 (4) | 1 (4) | 0 (0) |
Hematological AE a | All Grades, N (%) | Grade III–IV, N (%) |
---|---|---|
Anemia | 25 (100) | 20 (80) |
Neutropenia | 25 (100) | 25 (100) |
WBC b decreased | 25 (100) | 23 (92) |
Platelet level decreased | 25 (100) | 23 (92) |
Infection | 21 (84) | 19 (76) |
Red blood cell transfusion | 21 (84) | |
Platelet transfusion | 17 (68) | |
Neurological AE a | ||
Tinnitus | 1 (4) | |
Hearing loss | 0 (0) | |
Retinopathy | 0 (0) | |
CNS c ischemia (asymptomatic) | 5 (20) | |
CNS c ischemia (symptomatic) | 0 (0) | |
Other AE a | ||
Mucositis | 16 (64) | 5 (20) |
Nausea | 17 (68) | 3 (12) |
Deep vein thrombosis | 2 (8) | |
Pulmonary embolism | 4 (16) | |
Osteoporotic fracture | 2 (8) | |
High-dose treatment AE a | ||
Infection | 25 (100) | 25 (100) |
Mucositis | 23 (92) | 22 (88) |
Red blood cell transfusion | 19 (76) | |
Platelet transfusion | 25 (100) |
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Kuitunen, H.K.; Rönkä, A.L.K.; Sonkajärvi, E.M.; Isokangas, J.-M.; Pyörälä, M.; Palosaari, K.A.A.; Jokimäki, A.S.; Partanen, A.E.; Littow, H.J.; Vakkala, M.A.; et al. Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study. Cancers 2023, 15, 1341. https://doi.org/10.3390/cancers15041341
Kuitunen HK, Rönkä ALK, Sonkajärvi EM, Isokangas J-M, Pyörälä M, Palosaari KAA, Jokimäki AS, Partanen AE, Littow HJ, Vakkala MA, et al. Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study. Cancers. 2023; 15(4):1341. https://doi.org/10.3390/cancers15041341
Chicago/Turabian StyleKuitunen, Hanne K., Aino L. K. Rönkä, Eila M. Sonkajärvi, Juha-Matti Isokangas, Marja Pyörälä, Kari A. A. Palosaari, Anna S. Jokimäki, Anu E. Partanen, Harri J. Littow, Merja A. Vakkala, and et al. 2023. "Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study" Cancers 15, no. 4: 1341. https://doi.org/10.3390/cancers15041341