The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma

Hyunsoo Cho, Jong Hee Chang, Yu Ri Kim, Soo Jeong Kim, Haerim Chung, Hyunsung Park, Jung Yeon Lee, Ji Eun Jang, Yundeok Kim, Se Hoon Kim, Woo Ick Yang, Chang Ok Suh, June Won Cheong, Yoo Hong Min, Jin Seok Kim

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Upfront autologous stem cell transplantation (ASCT) has shown favourable outcome in patients with primary central nervous system lymphoma (PCNSL), but the role of risk-adapted upfront ASCT consolidation has not been evaluated in PCNSL. As PCNSL patients with the International Extranodal Lymphoma Study Group (IELSG) prognostic score ≥2 or those who did not achieve complete response after two courses of induction chemotherapy (non-CR1) have shown inferior outcomes, we retrospectively analysed the role of upfront ASCT in 66 high-risk (IELSG ≥2 and/or non-CR1) younger (age <65 years) immunocompetent PCNSL patients who achieved at least partial response after initial high-dose methotrexate-based chemotherapy. Nineteen patients who received upfront ASCT exhibited significantly better overall survival (OS, P = 0·021) and progression-free survival (PFS, P = 0·005) compared to 47 patients who did not. In univariate and multivariate analyses, upfront ASCT was associated with better OS (P = 0·037 and P = 0·025, respectively) and PFS (P = 0·009 and P = 0·007, respectively). In a propensity score-matched cohort (n = 36), patients who received upfront ASCT also showed better outcome (P = 0·037 for OS, P = 0·001 for PFS). Our results suggest that upfront ASCT consolidation might be especially beneficial for high-risk PCNSL patients.

Original languageEnglish
Pages (from-to)444-453
Number of pages10
JournalBritish Journal of Haematology
Volume174
Issue number3
DOIs
Publication statusPublished - 2016 Aug 1

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Stem Cell Transplantation
Lymphoma
Central Nervous System
Propensity Score
Induction Chemotherapy
Methotrexate
Disease-Free Survival
Multivariate Analysis
Drug Therapy
Survival

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Cho, Hyunsoo ; Chang, Jong Hee ; Kim, Yu Ri ; Kim, Soo Jeong ; Chung, Haerim ; Park, Hyunsung ; Lee, Jung Yeon ; Jang, Ji Eun ; Kim, Yundeok ; Kim, Se Hoon ; Yang, Woo Ick ; Suh, Chang Ok ; Cheong, June Won ; Min, Yoo Hong ; Kim, Jin Seok. / The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma. In: British Journal of Haematology. 2016 ; Vol. 174, No. 3. pp. 444-453.
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title = "The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma",
abstract = "Upfront autologous stem cell transplantation (ASCT) has shown favourable outcome in patients with primary central nervous system lymphoma (PCNSL), but the role of risk-adapted upfront ASCT consolidation has not been evaluated in PCNSL. As PCNSL patients with the International Extranodal Lymphoma Study Group (IELSG) prognostic score ≥2 or those who did not achieve complete response after two courses of induction chemotherapy (non-CR1) have shown inferior outcomes, we retrospectively analysed the role of upfront ASCT in 66 high-risk (IELSG ≥2 and/or non-CR1) younger (age <65 years) immunocompetent PCNSL patients who achieved at least partial response after initial high-dose methotrexate-based chemotherapy. Nineteen patients who received upfront ASCT exhibited significantly better overall survival (OS, P = 0·021) and progression-free survival (PFS, P = 0·005) compared to 47 patients who did not. In univariate and multivariate analyses, upfront ASCT was associated with better OS (P = 0·037 and P = 0·025, respectively) and PFS (P = 0·009 and P = 0·007, respectively). In a propensity score-matched cohort (n = 36), patients who received upfront ASCT also showed better outcome (P = 0·037 for OS, P = 0·001 for PFS). Our results suggest that upfront ASCT consolidation might be especially beneficial for high-risk PCNSL patients.",
author = "Hyunsoo Cho and Chang, {Jong Hee} and Kim, {Yu Ri} and Kim, {Soo Jeong} and Haerim Chung and Hyunsung Park and Lee, {Jung Yeon} and Jang, {Ji Eun} and Yundeok Kim and Kim, {Se Hoon} and Yang, {Woo Ick} and Suh, {Chang Ok} and Cheong, {June Won} and Min, {Yoo Hong} and Kim, {Jin Seok}",
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doi = "10.1111/bjh.14069",
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Cho, H, Chang, JH, Kim, YR, Kim, SJ, Chung, H, Park, H, Lee, JY, Jang, JE, Kim, Y, Kim, SH, Yang, WI, Suh, CO, Cheong, JW, Min, YH & Kim, JS 2016, 'The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma', British Journal of Haematology, vol. 174, no. 3, pp. 444-453. https://doi.org/10.1111/bjh.14069

The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma. / Cho, Hyunsoo; Chang, Jong Hee; Kim, Yu Ri; Kim, Soo Jeong; Chung, Haerim; Park, Hyunsung; Lee, Jung Yeon; Jang, Ji Eun; Kim, Yundeok; Kim, Se Hoon; Yang, Woo Ick; Suh, Chang Ok; Cheong, June Won; Min, Yoo Hong; Kim, Jin Seok.

In: British Journal of Haematology, Vol. 174, No. 3, 01.08.2016, p. 444-453.

Research output: Contribution to journalArticle

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T1 - The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma

AU - Cho, Hyunsoo

AU - Chang, Jong Hee

AU - Kim, Yu Ri

AU - Kim, Soo Jeong

AU - Chung, Haerim

AU - Park, Hyunsung

AU - Lee, Jung Yeon

AU - Jang, Ji Eun

AU - Kim, Yundeok

AU - Kim, Se Hoon

AU - Yang, Woo Ick

AU - Suh, Chang Ok

AU - Cheong, June Won

AU - Min, Yoo Hong

AU - Kim, Jin Seok

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Upfront autologous stem cell transplantation (ASCT) has shown favourable outcome in patients with primary central nervous system lymphoma (PCNSL), but the role of risk-adapted upfront ASCT consolidation has not been evaluated in PCNSL. As PCNSL patients with the International Extranodal Lymphoma Study Group (IELSG) prognostic score ≥2 or those who did not achieve complete response after two courses of induction chemotherapy (non-CR1) have shown inferior outcomes, we retrospectively analysed the role of upfront ASCT in 66 high-risk (IELSG ≥2 and/or non-CR1) younger (age <65 years) immunocompetent PCNSL patients who achieved at least partial response after initial high-dose methotrexate-based chemotherapy. Nineteen patients who received upfront ASCT exhibited significantly better overall survival (OS, P = 0·021) and progression-free survival (PFS, P = 0·005) compared to 47 patients who did not. In univariate and multivariate analyses, upfront ASCT was associated with better OS (P = 0·037 and P = 0·025, respectively) and PFS (P = 0·009 and P = 0·007, respectively). In a propensity score-matched cohort (n = 36), patients who received upfront ASCT also showed better outcome (P = 0·037 for OS, P = 0·001 for PFS). Our results suggest that upfront ASCT consolidation might be especially beneficial for high-risk PCNSL patients.

AB - Upfront autologous stem cell transplantation (ASCT) has shown favourable outcome in patients with primary central nervous system lymphoma (PCNSL), but the role of risk-adapted upfront ASCT consolidation has not been evaluated in PCNSL. As PCNSL patients with the International Extranodal Lymphoma Study Group (IELSG) prognostic score ≥2 or those who did not achieve complete response after two courses of induction chemotherapy (non-CR1) have shown inferior outcomes, we retrospectively analysed the role of upfront ASCT in 66 high-risk (IELSG ≥2 and/or non-CR1) younger (age <65 years) immunocompetent PCNSL patients who achieved at least partial response after initial high-dose methotrexate-based chemotherapy. Nineteen patients who received upfront ASCT exhibited significantly better overall survival (OS, P = 0·021) and progression-free survival (PFS, P = 0·005) compared to 47 patients who did not. In univariate and multivariate analyses, upfront ASCT was associated with better OS (P = 0·037 and P = 0·025, respectively) and PFS (P = 0·009 and P = 0·007, respectively). In a propensity score-matched cohort (n = 36), patients who received upfront ASCT also showed better outcome (P = 0·037 for OS, P = 0·001 for PFS). Our results suggest that upfront ASCT consolidation might be especially beneficial for high-risk PCNSL patients.

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