Mainguy Adam, Soussain Carole, Touitou Valérie, Bennedjai Amin, Kodjikian Laurent, Ghesquières Hervé, Damaj Gandhi, Gressin Rémy, Ducloyer Jean-Baptiste, Chinot Olivier, Vautier Anaïs, Moluçon-Chabrot Cécile, Ahle Guido, Taillandier Luc, Marolleau Jean Pierre, Chauchet Adrien, Jardin Fabrice, Cassoux Nathalie, Malaise Denis, Toutée Adélaïde, Touhami Sara, Le Garff-Tavernier Magali, Hoang-Xuan Khê, Choquet Sylvain, Houillier Caroline
Sorbonne Université, Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Paris, France.
Angers University, Department of Ophthalmology, Angers University Hospital, Angers, France.
Bone Marrow Transplant. 2025 Mar;60(3):297-304. doi: 10.1038/s41409-024-02477-y. Epub 2024 Nov 19.
Despite its indolent evolution, vitreoretinal lymphoma (VRL) has a poor prognosis due to a major risk of relapse in the central nervous system (CNS) and may necessitate aggressive therapy. However, the use of high-dose chemotherapy with autologous stem cell transplantation (HCT-ASCT) is poorly documented. We retrospectively analysed from the French LOC network database the adult immunocompetent patients treated with HCT-ASCT for isolated VRL. Thirty-eight patients underwent consolidation with HCT-ASCT for isolated VRL between 2008 and 2019 after induction chemotherapy. Twenty patients had primary VRL, and 18 had an isolated VRL relapse of a primary CNS lymphoma. Three patients underwent HCT-ASCT in first-line treatment, 24 in second-line treatment, and 11 in subsequent lines. At HCT-ASCT, the median age was 61 years, and the median KPS was 90. Thirty-two patients (84%) received high-dose thiotepa-based HCT. One patient (3%) died from HCT-ASCT toxicity. Nineteen (50%) patients relapsed after HCT-ASCT, including 17 cases occurring in the brain. The median progression-free survival, brain-free survival and overall survival from HCT-ASCT were 96, 113 and 92 months, respectively. HCT-ASCT represents an effective therapeutic strategy for select VRL patients, with a tolerable safety profile. However, the risk of subsequent brain relapse remains significant.
尽管玻璃体视网膜淋巴瘤（VRL）进展缓慢，但由于中枢神经系统（CNS）复发风险高，其预后较差，可能需要积极治疗。然而，高剂量化疗联合自体干细胞移植（HCT-ASCT）的应用报道较少。我们从法国LOC网络数据库中回顾性分析了接受HCT-ASCT治疗的孤立性VRL成年免疫功能正常患者。2008年至2019年期间，38例患者在诱导化疗后接受了HCT-ASCT巩固治疗孤立性VRL。20例为原发性VRL，18例为原发性中枢神经系统淋巴瘤的孤立性VRL复发。3例患者在一线治疗中接受HCT-ASCT，24例在二线治疗中接受，11例在后续治疗中接受。在进行HCT-ASCT时，中位年龄为61岁，中位KPS为90。32例患者（84%）接受了以高剂量噻替派为基础的HCT。1例患者（3%）死于HCT-ASCT毒性。19例患者（50%）在HCT-ASCT后复发，其中17例发生在脑部。HCT-ASCT后的中位无进展生存期、无脑生存期和总生存期分别为96个月、113个月和92个月。HCT-ASCT对部分VRL患者是一种有效的治疗策略，安全性可耐受。然而，后续脑部复发的风险仍然很高。
