High-dose chemotherapy with autologous haemopoietic stem cell transplantation for newly diagnosed primary CNS lymphoma: a prospective, single-arm, phase 2 trial

High‐dose chemotherapy with thiotepa, busulfan, and cyclophosphamide and autologous stem cell transplantation for patients with primary central nervous system lymphoma in first complete remission

“…Busulfan and thiotepa, which have excellent penetration into the CNS, have become the backbone of the TBC regimen, the use of which has been reported in the management of patients with PCNSL and secondary CNS lymphoma . Several studies have been published to date that used CNS‐directed conditioning regimens as consolidative therapy for patients with PCNSL in CR1 (Table ) . A recent phase 2 trial treated patients newly diagnosed with PCNSL with the combination of rituximab, MTX, procarbazine, and vincristine followed by HDC‐ASCT using TBC conditioning and found excellent disease control (2‐year OS and PFS rates of 81% and 81%, respectively), an acceptable toxicity profile, and minimal neurotoxicity on prospective neuropsychological evaluations .…”

“…[16][17][18][19][20] Several studies have been published to date that used CNS-directed conditioning regimens as consolidative therapy for patients with PCNSL in CR1 (Table 3). 5,[16][17][18][21][22][23] A recent phase 2 trial treated patients newly diagnosed with PCNSL with the combination of rituximab, MTX, procarbazine, and vincristine followed by HDC-ASCT using TBC conditioning and found excellent disease control (2-year OS and PFS rates of 81% and 81%, respectively), an acceptable toxicity profile, and minimal neurotoxicity on prospective neuropsychological evaluations. 21 Another CNS-directed conditioning regimen has been the combination of carmustine and thiotepa, which has been investigated in several studies.…”

High-dose thiotepa-based chemotherapy with autologous stem cell support in elderly patients with primary central nervous system lymphoma: a European retrospective study

“…8,9 For younger patients, thiotepa-containing high-dose chemotherapy followed by autologous stem cell transplantation (HDT-ASCT) has been shown to be feasible and effective in both newly diagnosed and relapsed patients with PCNSL. [10][11][12][13][14][15] Because of toxicity and tolerability concerns, this intensive central nervous system-directed treatment has typically been restricted to patients o65 years of age. However, age alone may not be the appropriate criterion to select patients for this effective treatment approach.…”

Durable Survival Outcomes in Primary and Secondary Central Nervous System Lymphoma After High-dose Chemotherapy and Autologous Stem Cell Transplantation Using a Thiotepa, Busulfan, and Cyclophosphamide Conditioning Regimen

“…Despite data that support the use of HDC/ASCT in patients with NHL involving the CNS as both post-remission consolidation 5,6,8,[10][11][12][13][14][15][16][17][18][21][22][23][24][25][26] and in the relapsed/refractory setting, 8,9,19,20,[28][29][30][31] several unanswered questions remain in regards to ideal patient candidates, optimal conditioning, and timing of transplant. Furthermore, the efficacy and toxicity compared to WBRT or non-myeloablative chemotherapy is still incompletely characterized.…”

“…High-dose chemotherapy with autologous stem cell transplantation (HDC/ASCT) has been investigated as post-remission consolidation or in relapsed disease with promising results. [5][6][7][8][9] HD-MTX-based induction regimens followed by ASCT with various conditioning regimens, including BEAM (carmustine/etoposide/cytarabine/melphalan), 5,6,10 thiotepa/busulfan, 11,12 TBC (thiotepa/busulfan/cyclophosphamide), 8,9,[13][14][15][16][17][18][19][20] and thiotepa/carmustine [21][22][23][24][25][26] have been evaluated.…”