International Journal of Hematology

DOI: 10.1007/s12185-015-1874-1 Pages: 678-688

Efficacy and feasibility of autologous stem cell transplantation in patients with diffuse large B-cell lymphoma with secondary central nervous system involvement

1. Sungkyunkwan University School of Medicine, Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center

2. Sungkyunkwan University School of Medicine, Department of Laboratory Medicine, Samsung Medical Center

3. Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center

4. Sungkyunkwan University, Department of Medical Device Management and Research, SAIHST

Correspondence to:
Seok Jin Kim
Tel: +82-2-3410-1766
Email: kstwoh@skku.edu

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Abstract

Secondary central nervous system (CNS) involvement is a fatal complication of diffuse large B-cell lymphoma (DLBCL). We evaluated the efficacy and feasibility of high-dose chemotherapy containing busulfan and thiotepa followed by autologous stem cell transplantation (HDC-ASCT) in DLBCL with secondary CNS involvement. Thirty-one patients with secondary CNS involvement including CNS involvement at diagnosis (n = 9), isolated CNS relapse (n = 14), and CNS involvement with systemic disease progression or relapse (n = 8) were selected and analyzed from our prospective cohorts. Of these, 12 patients, including seven with isolated CNS relapse, successfully completed HDC-ASCT without engraftment failure or transplantation-related mortality. After ASCT, six patients were alive; however, three patients experienced post-transplantation relapse. With a median follow-up of 29 months after secondary CNS involvement, the median overall survival of 31 patients was 9 months (95 % CI 5–12 months). The survival outcomes of patients who had undergone HDC-ASCT were significantly better than those of patients who did not (p < 0.01). Accordingly, patients with isolated CNS relapse tended to have a longer survival outcome than other cases. Our results suggest that HDC-ASCT may provide survival benefits in DLBCL patients with secondary CNS involvement, especially in case of isolated CNS relapse.

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