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Results of intensive chemotherapy followed by hematopoietic stem‐cell rescue in 22 patients with refractory or recurrent primary CNS lymphoma or intraocular lymphoma Volume 91, issue 2, Février 2004

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Authors
Service d‘hématologie clinique, CHG, 6‐8 rue Saint‐Fiacre, BP 218, 77104 Meaux Cédex Service de neurologie, GH Pitié‐Salpêtrière, 47‐83 boulevard de l‘Hôpital, 75013 Paris Centre d‘investigations cliniques, hôpital Saint‐Louis, 1 rue Claude‐Vellefaux, 75010 Paris

Rescue therapies for relapsing\refractory primary central nervous system lymphoma (PCNSL) and intraocular lymphoma (IOL) remain a challenging problem for clinicians. In 2001, we published encouraging results for 22 patients treated at relapse with a CYVE regimen combining high doses of Ara‐C (50 mg\m 2\d in 12 hours infusion d1 through d5; 2 g\m 2\d d2 through d5) and VP16 (200 mg\m 2\d d2 through d5), followed by intensive chemotherapy based on high doses of thiotepa (250 mg\m 2\d d‐9 through d‐7), busulfan (10 mg\kg total dose d‐6 through d‐4) and cyclophosphamide (60 mg\kg\d, d‐3 and d‐2 with hematopoietic cell rescue at d0. Patients were enrolled onto the study for a relapse (n ∓ 10; 2 IOL, 3 CSF, 5 brain lesion) or for a refractory disease (n ∓ 12; 9 IOL, 3 brain lesion). CYVE rescue was not administered to patients with refractory IOL who had previously received high doses of methotrexate and Ara‐C as part of their first‐line treatment. Twenty patients received the intensive chemotherapy and hematopoietic cells rescue. We updated our results in March 2003. Seven patients had neurologic adverse events during the entire procedure. With a median follow up of 6.2 years, the median overall survival is 91 months, and the median survival after intensive chemotherapy has not been reached. ▴