Department of Hematology, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Department of Hematology, School of Medicine, Nankai University, Tianjin, China (mainland).
Ann Transplant. 2023 Jan 3;28:e938467. doi: 10.12659/AOT.938467.
BACKGROUND Myeloablative chemotherapy supported by autologous stem cell transplantation (ASCT) is an option for primary central nervous system lymphoma (PCNSL) in both the relapse setting and as postremission consolidation, but the level of evidence in this field is still low. MATERIAL AND METHODS We retrospectively analyzed 47 HIV-negative PCNSL patients from 2010 to 2021. To assess the outcomes in patients undergoing ASCT. RESULTS Of the 47 patients, the median age was 51 (range, 21-77) years, and 28 (59.6%) were male. After induction, 33 (70.2%) patients achieved complete remission, and 6 (12.8%) patients achieved partial remission. At a median follow-up of 21.4 months (95% CI 8.86-33.95), the median progression-free survival (PFS) was 23.3 months (95% CI 14.87-31.73), and the 4-year PFS rate was 14.6%. The median overall survival (OS) time was 62.4 months (95% CI 41.93-82.87), and the 4-year OS rate was 71.5%. Among 20 patients who received ASCT (10 consolidation, 10 salvage), the 4-year PFS and 4-year OS rates were 57.3% and 71.2%, respectively. In the multivariate analysis, ASCT therapy (hazard ratio [HR] 0.16, P=0.016) and early remission (HR 0.12, p=0.003) were found to be independent prognostic factors for a longer PFS. Two treatment-related deaths occurred in patients with multiple relapses before ASCT. Pancytopenia and diarrhea were the most common adverse events. CONCLUSIONS ASCT offers potential long-term PFS with good tolerability for patients with PCNSL. Our retrospective cohort adds to the currently available literature and identifies disease status after induction as a significant factor affecting survival.
自体干细胞移植（ASCT）支持的大剂量化疗是原发性中枢神经系统淋巴瘤（PCNSL）复发患者和缓解后巩固治疗的选择，但该领域的证据水平仍然较低。
我们回顾性分析了 2010 年至 2021 年间的 47 例 HIV 阴性 PCNSL 患者。评估 ASCT 患者的结局。
47 例患者的中位年龄为 51 岁（范围 21-77 岁），28 例（59.6%）为男性。诱导后，33 例（70.2%）患者达到完全缓解，6 例（12.8%）患者达到部分缓解。中位随访 21.4 个月（95%CI 8.86-33.95），中位无进展生存期（PFS）为 23.3 个月（95%CI 14.87-31.73），4 年 PFS 率为 14.6%。中位总生存期（OS）为 62.4 个月（95%CI 41.93-82.87），4 年 OS 率为 71.5%。20 例接受 ASCT 治疗的患者（10 例巩固治疗，10 例挽救治疗），4 年 PFS 和 4 年 OS 率分别为 57.3%和 71.2%。多因素分析显示，ASCT 治疗（风险比[HR]0.16，P=0.016）和早期缓解（HR 0.12，p=0.003）是 PFS 延长的独立预后因素。2 例接受多次复发前 ASCT 治疗的患者发生治疗相关死亡。全血细胞减少和腹泻是最常见的不良事件。
ASCT 为 PCNSL 患者提供了潜在的长期 PFS 获益，且具有良好的耐受性。我们的回顾性队列研究结果增加了目前的文献资料，并确定诱导后疾病状态是影响生存的一个重要因素。
