Methotrexate plus idarubicin improves outcome of patients with primary central nervous system lymphoma

Abstract

Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma with poor long-term survival. This study assessed methotrexate (MTX) plus idarubicin (IDA) in treating patients of PCNSL comparing to MTX alone therapy. A total of 100 patients were retrospectively enrolled and subjected to MTX alone (n = 52) and MTX plus IDA (n = 48). The completed response (CR) rate in patients treated with MTX plus IDA was 62.50%, and overall response (OR) rate was 79.17%, which in MTX alone cohort were 42.31% and 63.46% respectively. Median progression-free survival (PFS) of patients treated with MTX plus IDA was significantly better than those treated with MTX alone (18.35 months vs.8.45months, P = 0.000). The MTX plus IDA regimen exhibited a significantly better control of PCNSL. Further studies would be needed to confirm these results.

Balancing relapses versus cognitive impairment in primary central nervous system lymphoma: a single-center experience

“…The high-dose MTX-based regimens were shown to be effective treatments with manageable toxicities for newly diagnosed PCNSL patients including the elderly. The ORR and CR rates after MTX-based regimens were comparable to previous studies [4][5][6][7]17,[30][31][32]. The CR is the primary goal for PCNSL treatment due to significant OS benefit.…”

R-IDARAM treatment in central nervous system lymphomas: A single-center experience and review of the literature

“…High-dose methotrexate (HD-MTX) plus cytarabine arabinoside (Ara-C) are known as the most effective chemotherapeutics for CNSL and associated with higher response rates. [ 3 4 5 ] In the last decade, Moreton et al [ 6 ] developed the IDARAM protocol, which comprised idarubicin (10mg/m 2 , intravenous [IV], days 1 and 2), dexamethasone (100mg, 12-h infusion, days 1, 2, and 3), Ara-C (1.0 g/m 2 , 1-h infusion, days 1 and 2), MTX (2.0 g/m 2 , 6-h infusion, day 3), and folinic acid rescue. In addition, intrathecal cytosine arabinoside (70 m) and MTX (12mg, days 1 and 8) was administered until 3 weeks after the clearance of abnormal cells in cerebrospinal fluid.…”