High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study)

Fritsch K, Kasenda B, Schorb E, Hau P, Bloehdorn J, Moehle R, Loew S, Binder M, Atta J, Keller U, Wolf HH, Krause S, Hess G, Naumann R, Sasse S, Hirt C, Lamprecht M, Martens U, Morgner A, Panse J, Frickhofen N, Roeth A, Hader C, Deckert M, Fricker H, Ihorst G, Finke J, Illerhaus G (2016)

Publication Type: Journal article

Publication year: 2016

Journal

DOI: 10.1038/leu.2016.334

Abstract

To investigate immuno-chemotherapy for elderly immuno-competent patients (?65 years) with newly diagnosed primary central nervous system lymphoma, we conducted a multicentre single-arm trial. One cycle consisted of rituximab (375 mg/m(2), days 1, 15, 29), high-dose methotrexate (3 g/m(2) days 2, 16, 30), procarbazine (60 mg/m(2) days 2-11) and lomustine (110 mg/m(2), day 2)-R-MPL protocol. Owing to infectious complications, we omitted lomustine during the study and consecutive patients were treated with the R-MP protocol. Three cycles were scheduled and repeated on day 43. Subsequently, patients commenced 4 weekly maintenance treatment with procarbazine (100 mg for 5 days). Primary end point was complete remission (CR) after 3 cycles. We included 107 patients (69 treated with R-MPL and 38 with R-MP). In all, 38/107 patients achieved CR (35.5%) and 15 (14.0%) achieved partial remission. R-MP was associated with a lower CR rate (31.6%) compared with R-MPL (37.7%), but respective 2-year progression-free survival (All 37.3%; R-MP 34.9%; R-MPL 38.8%) and overall survival (All 47.0%; R-MP 47.7%; R-MPL 46.0%) rates were similar. R-MP was associated with less ?grade 3 toxicities compared with R-MPL (71.1% vs 87.0%). R-MP is more feasible while still associated with similar efficacy compared with R-MPL and warrants further improvement in future studies.Leukemia advance online publication, 9 December 2016; doi:10.1038/leu.2016.334.

Authors with CRIS profile

Involved external institutions

Klinikum Stuttgart Germany (DE) Universitätsklinikum Freiburg Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Universitätsklinikum Köln Germany (DE) Universitätsklinikum Essen Germany (DE) HELIOS Kliniken Germany (DE) Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen Germany (DE) Klinikum Chemnitz Germany (DE) SLK-Kliniken Heilbronn GmbH Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Universität Greifswald Germany (DE) Gemeinschaftsklinikum Mittelrhein Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) Germany (DE) Universitätsklinikum Halle (Saale) Germany (DE) Technische Universität München (TUM) Germany (DE) Goethe-Universität Frankfurt am Main Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) Universität Ulm Germany (DE) Universitätsklinikum Regensburg Germany (DE)

How to cite

APA:

Fritsch, K., Kasenda, B., Schorb, E., Hau, P., Bloehdorn, J., Moehle, R.,... Illerhaus, G. (2016). High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study). Leukemia. https://dx.doi.org/10.1038/leu.2016.334

MLA:

Fritsch, K., et al. "High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study)." Leukemia (2016).

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