Wu Yuchen, Sun Xuefei, Bai Xueyan, Qian Jun, Zhu Hong, Cui Qu, Xing Ruixian, Chen Yuedan, Liu Qing, Lai Wenyuan, Li Junhong, Wang Yaming, Sun Shengjun, Ji Nan, Liu Yuanbo
Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China.
Chin Neurosurg J. 2021 Apr 2;7(1):20. doi: 10.1186/s41016-021-00238-0.
Secondary central nervous system lymphoma (SCNSL) is defined as lymphoma involvement within the central nervous system (CNS) that originated elsewhere, or a CNS relapse of systemic lymphoma. Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined.
We conducted a retrospective study to assess the feasibility of an R-MIADD (rituximab, high-dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, and dexamethasone) regimen for SCNSL patients.
Nineteen patients with newly diagnosed CNS lesions were selected, with a median age of 58 (range 20 to 72) years. Out of 19 patients, 11 (57.9%) achieved complete remission (CR) and 2 (10.5%) achieved partial remission (PR); the overall response rate was 68.4%. The median progression-free survival after CNS involvement was 28.0 months (95% confidence interval 11.0-44.9), and the median overall survival after CNS involvement was 34.5 months. Treatment-related death occurred in one patient (5.3%).
These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL, further investigation is warranted.
继发性中枢神经系统淋巴瘤（SCNSL）定义为起源于其他部位的淋巴瘤累及中枢神经系统（CNS），或系统性淋巴瘤的CNS复发。SCNSL的预后较差，最合适的治疗方法仍未确定。
我们进行了一项回顾性研究，以评估R-MIADD（利妥昔单抗、大剂量甲氨蝶呤、异环磷酰胺、阿糖胞苷、脂质体多柔比星和地塞米松）方案用于SCNSL患者的可行性。
选择了19例新诊断为CNS病变的患者，中位年龄为58岁（范围20至72岁）。19例患者中，11例（57.9%）达到完全缓解（CR），2例（10.5%）达到部分缓解（PR）；总缓解率为68.4%。CNS受累后的中位无进展生存期为28.0个月（95%置信区间11.0 - 44.9），CNS受累后的中位总生存期为34.5个月。1例患者（5.3%）发生治疗相关死亡。
这些单中心数据强调了R-MIADD方案作为SCNSL诱导治疗的可行性，有必要进行进一步研究。
