Comparison of Thiotepa-based Conditioning Regimens for Older Adults with Primary Diffuse Large B-cell Lymphoma of the Central Nervous System Undergoing Autologous Hematopoietic Cell Transplantation. Transplant Cell Ther 2024 Dec;30(12):1191.e1-1191.e8
Date
09/21/2024Pubmed ID
39303985DOI
10.1016/j.jtct.2024.09.015Scopus ID
2-s2.0-85206435293 (requires institutional sign-in at Scopus site)Abstract
In this study, we compare outcomes of older patients with primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) undergoing autologous hematopoietic cell transplantation (autoHCT) with either thiotepa/carmustine (BCNU/Thio) or thiotepa/busulfan/cyclophosphamide (TBC) conditioning. We used a postpublication dataset made available by the Center for International Blood and Marrow Transplantation Research including patients who were ≥65 years in age with PCNSL and underwent autoHCT as consolidation with TBC or BCNU/Thio conditioning. Out of 147 patients; n = 84 received BCNU/Thio and n = 63 received TBC. The 1-year NRM in the BCNU/Thio group was 10% versus 22% in the TBC group (P = .05) and the 2-year relapse rate was 5% versus 5%, respectively (P = 1.00). The 2-year progression-free survival (PFS) in the BCNU/Thio group was 85% versus 71% in the TBC group (P = .05) and 2-year overall survival (OS) was 86% versus 74% (P = .08). In a multivariable regression model, BCNU/Thio was associated with a lower risk for NRM (hazard ratio [HR], 0.33, P = .009), improved PFS (HR, 0.41, P = .008) and OS (HR, 0.37, P = .007), but there was no association with relapse risk. We found that in older adults with PCNSL undergoing consolidation with autoHCT, BCNU/Thio conditioning is associated with lower NRM and improved OS compared to TBC.
Author List
Akhtar OS, Arshad S, Lian Q, Ahn KW, D'Souza A, Dhakal B, Mohan M, Pasquini M, Longo W, Shah NN, Fenske TS, Hamadani MAuthors
Kwang Woo Ahn PhD Director, Professor in the Data Science Institute department at Medical College of WisconsinOthman S. Akhtar MBBS Assistant Professor in the Medicine department at Medical College of Wisconsin
Anita D'Souza MD Professor in the Medicine department at Medical College of Wisconsin
Binod Dhakal MD Associate Professor in the Medicine department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Walter L. Longo MD Professor in the Medicine department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin
Nirav N. Shah MD Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAntineoplastic Combined Chemotherapy Protocols
Busulfan
Carmustine
Central Nervous System Neoplasms
Cyclophosphamide
Female
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, Large B-Cell, Diffuse
Male
Thiotepa
Transplantation Conditioning
Transplantation, Autologous
