Treatment of Primary CNS Lymphoma (PCNSL) Following Successful Treatment of Systemic Non-Hodgkins Lymphoma (NHL) (P04.186)

Abstract

Objective: Illustrate a treatment approach for PCNSL following successful treatment of a systemic NHL. Background Treatment of PCNSL occurring after successful treatment of systemic NHL is ill defined. Design/Methods: A retrospective case series of 6 patients (mean age 60 years; range 46-60) diagnosed with a diffuse large B-cell NHL of the CNS follwing prior successful treatment with a systemic NHL (low grade in 2; high grade in 4). Mean interval to diagnosis of PCNSL after diagnosis of systemic NHL was 12 months (range 7-18). In 4/6patients in whom genetic analysis could be performed, the PCNSL and NHL differed. Treatment utilized high-dose methotrexate and rituximab followed in patients with a radiographic complete response by autologous peripheral stem cell transplant (PSCT) with total body irradiation and multiagent conditioning chemotherapy (BEAM). Results: 5/6 patients responded to immunochemotherapy and were treated with PSCT. 4/5 patients were free of disease following PSCT with a mean follow-up of 2 years (range 0.5-4 years). There were no toxic deaths and all patients transplanted successfully engrafted. Conclusions: Using a treatment paradigm similar to that utilized for recurrent systemic NHL (induction chemotherapy followed by autologous PSCT), PCNSL occuring metachronously after successful treatment of systemic NHL appears safe and effective. Disclosure: Dr. Chamberlain has received personal compensation for activities with Sigma-Tau, Genentech, Inc., Roche Diagnostics Corporation, Myriad, and Schering-Plough Corporation. Dr. Chamberlain has received compensation for serving on the boards of Genentech/Roche, Sigma Tau/Enzon, and Myrexis/Myriad. Dr. Chamberlain has received research support from Exelixis, MedImmune, NCCN, and Northwestern University/Genentech, Inc.