Professional paper
CAN A REDUCED DOSE OF CYTARABINE BE AS EFFECTIVE AS FULL DOSE IN THE TREATMENT OF PRIMARY DIFFUSE B-CELL LYMPHOMA IN MATRix PROTOCOL?
KLARA BRČIĆ
orcid.org/0000-0002-1719-1195
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
GORAN RINČIĆ
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
SABINA NOVAKOVIĆ COHA
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
HANA MATIJACA
; Sestre milosrdnice University Hospital Center, Zagreb; University of Zagreb, School of Medicine, Zagreb, Croatia
TOMISLAV BRBLIĆ
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
DAJANA DEAK
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
DARIO JOSIP ŽIVKOVIĆ
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
PETAR GAĆINA
; Sestre milosrdnice University Hospital Center, Zagreb; University of Zagreb, School of Dental Medicine, Department of Internal Medicine, Zagreb, Croatia
Abstract
Primary diffuse B-cell brain lymphoma is a rare, aggressive non-Hodgkin’s lymphoma. The modern approach to treatment involves two phases, induction and consolidation. IELSG32, a randomized trial by the International Extranodal Lymphoma Study Group, showed that in the induction phase, the combination of high doses of methotrexate, cytarabine, thiotepa, and rituximab followed by consolidation therapy with autologous hematopoietic stem cell transplantation signifi cantly improved outcomes in these patients. We aim here to present characteristics and outcomes of seven patients with newly diagnosed primary central nervous system lymphoma who were treated between November 2018 and February 2022. All of them received the MATRix reduced-dose cytarabine chemotherapy protocol. The dose of cytarabine was 2000 mg/ m2 every 12 hours on the third day of the cycle. On the fourth day of the cycle, cytarabine was completely omitted in all patients. Five patients achieved complete remission and one patient achieved partial remission after completion of the induction therapy at a reduced dose, followed by autologous hematopoietic stem cell transplantation in most patients. One patient had progression of the disease three months after autologous hematopoietic stem cell transplantation. Therapeutic toxicities were similar to IELSG32 results with emphasis on the fact that hematologic toxicities of grade 4 occurred in a low percentage. The above raises a question whether a reduced dose of cytarabine in MATRix protocol be as effective as full dose in achieving disease remission.
Keywords
lymphoma; large B-cell; diffuse; therapy; brain neoplasms; cytarabine; therapeutic use; remission induction; treatment outcome
Hrčak ID:
285256
URI
Publication date:
7.11.2022.
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