Consolidation With Autologous Stem Cell Transplantation In Patients With Primary Central Nervous System Lymphoma

INTRODUCTION: Primary central nervous system lymphomas (PCNSL) are defined as a rare extranodal Non-Hodgkin lymphoma subgroup. The induction regimens involve high dose methotrexate-based chemotherapies mostly for the patients with PCNSL. There is still no standard approach for consolidation therapy. Recently, consolidation with autologous stem cell transplantation (ASCT) after high-dose chemotherapy has been widely used in the treatment of PCNSL. We aim to evaluate the results of PCNS patients who underwent ASCT in our center.
METHODS: The data of PCNSL patients diagnosed in Hematology Unit of Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital between 2010 and 2021 were analyzed retrospectively.
RESULTS: Eleven patients were diagnosed with PCNSL diagnosis. The patients' median age included in the study was 53.5 years (range 38-68). Eight patients underwent ASCT for upfront consolidation. Seven patients achieved CR three months after ASCT; one patient was not evaluated due to exitus in the first month of the transplant. Three patients could not achieve ASCT due to transplantation ineligibility patients and mobilization failure. The median follow-up period in the study was 26 months (range 8-82 months). The median overall survival was not reached. Transplant-related mortality was 12.5%, and the mortality rate was 27% in the whole cohort. In patients who received ASCT, of the 62.5 % had an almost two-year survival advantage. For the whole cohort, 73% of the patients had change for more prolonged survival among follow-up.
DISCUSSION AND CONCLUSION: In our cohort, the PCNSL patients had mostly high-risk disease; however, three-quarters of the patients could receive ASCT, and at the same rate of the patients had advantages for long-term survival.

Primer Santral Sinir Sistem Lenfomalarýnda Otolog Kök Hücre Nakli Ýle Konsolidasyon Sonuçlarý

GÝRÝÞ ve AMAÇ: Primer santral sinir sistemi lenfomalarý (PSSSL) nadir görülen bir ekstranodal Non-Hodgkin lenfoma alt grubu olarak tanýmlanmaktadýr. Ýndüksiyon tedavileri, çoðunlukla PSSSL'li hastalar için yüksek doz metotreksat bazlý kemoterapileri içerir. Konsolidasyon tedavisi için hala standart bir yaklaþým yoktur. Son zamanlarda, yüksek doz kemoterapi sonrasý otolog kök hücre transplantasyonu (OKHN) ile konsolidasyon tedavide yaygýn olarak kullanýlmaktadýr. Bu çalýþmada, merkezimizde OKHN uygulanan PSSSL hastalarýnýn sonuçlarýný deðerlendirmeyi hedefliyoruz.
YÖNTEM ve GEREÇLER: Dr. Abdurrahman Yurtaslan Ankara Onkoloji Hastanesi Hematoloji Ünitesi'nde 2010-2021 yýllarý arasýnda taný konulan PSSSL hastalarýnýn verileri geriye dönük olarak incelendi.
BULGULAR: On bir hastaya PSSSL tanýsý konuldu. Çalýþmaya dahil edilen hastalarýn medyan yaþý 53.5 yýl (38-68) idi. Sekiz hastaya indüksiyon tedavisi sonrasý upfront konsolidasyon amacýyla OKHN uygulandý. Yedi hasta OKHN'den üç ay sonra tam yanýta ulaþtý; bir hasta naklin ilk ayýnda çýkýþ nedeniyle deðerlendirilmedi. Üç hastaya, transplantasyona uygun olmamalarý ve mobilizasyon baþarýsýzlýðý nedeniyle OKHN yapýlamadý. Çalýþmadaki ortanca takip süresi 26 aydý (8-82 ay). Median genel saðkalýma ulaþýlmadý. Nakille iliþkili mortalite % 12.5 ve tüm kohortta mortalite oraný % 27 idi. OKHN olmuþ hastalarýn % 62.5’unda iki yýla yakýn toplam saðkalým avantajý saptandý. Tüm kohort için hastalarýn %73'ü takipte daha uzun süreli saðkalým þansý saðlamýþtýr.
TARTIÞMA ve SONUÇ: Bizim kohortumuzda, PSSSL hastalarý çoðunlukla yüksek riskli hastalýða sahip olmasýna raðmen hastalarýn dörtte üçü OKHN olabildi ve ayný oranda hasta uzun süreli saðkalým avantajý saðladý.