Gaut Daria, Schiller Gary J
Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Hematological Malignancies/Stem Cell Transplantation Unit, Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Room 42-121 CHS, Los Angeles, CA, 90095, USA.
Int J Hematol. 2019 Mar;109(3):260-277. doi: 10.1007/s12185-019-02594-1. Epub 2019 Jan 22.
Primary central nervous system lymphoma (PCNSL) is an uncommon variant of extranodal non-Hodgkin lymphoma (NHL) with an aggressive course and worse outcomes compared with other lymphomas of similar tumor burden and histologic subtype. High-dose chemotherapy supported by autologous stem cell transplantation (HDC/ASCT) is an option for therapy for this disease in both the relapse setting and as post-remission consolidation. Data are currently limited to only several single-arm phase II trials with small sample sizes, but randomized trials are now ongoing. In this review, we discuss the efficacy, feasibility, and toxicity of HDC/ASCT for PCNSL and its role in the treatment of this aggressive malignancy, both in the first-line and relapse settings. We also bring to attention the current data on allogeneic stem cell transplantation (allo-SCT) in PCNSL.
原发性中枢神经系统淋巴瘤(PCNSL)是结外非霍奇金淋巴瘤(NHL)的一种罕见变体,与具有相似肿瘤负荷和组织学亚型的其他淋巴瘤相比,病程侵袭性更强,预后更差。自体干细胞移植支持下的大剂量化疗(HDC/ASCT)是该疾病在复发情况下以及缓解后巩固治疗中的一种治疗选择。目前的数据仅限于几项样本量较小的单臂II期试验,但随机试验正在进行中。在本综述中,我们讨论了HDC/ASCT治疗PCNSL的疗效、可行性和毒性,以及其在一线和复发情况下治疗这种侵袭性恶性肿瘤中的作用。我们还提请关注PCNSL中异基因干细胞移植(allo-SCT)的当前数据。