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High-dose methotrexate with or without rituximab in newly diagnosed primary CNS lymphoma
| Content Provider | Scilit |
|---|---|
| Author | Holdhoff, Matthias Ambady, Prakash Abdelaziz, Ahmed Sarai, Guneet Bonekamp, David Blakeley, Jaishri Grossman, Stuart A. Ye, Xiaobu |
| Copyright Year | 2014 |
| Description | Journal: Neurology Objective: To evaluate the efficacy of rituximab (R) when added to high-dose methotrexate (HD-MTX) in patients with newly diagnosed immunocompetent primary CNS lymphomas (PCNSLs). Methods: Immunocompetent adults with newly diagnosed PCNSL treated at The Johns Hopkins Hospital between 1995 and 2012 were investigated. From 1995 to 2008, patients received HD-MTX monotherapy (8 $g/m^{2}$ initially every 2 weeks and after complete response [CR] monthly to complete 12 months of therapy). From 2008 to 2012, patients received the same HD-MTX with rituximab (375 $mg/m^{2}$) with each HD-MTX treatment. CR rates and median overall and progression-free survival were analyzed for each patient cohort in this single-institution, retrospective study. Results: A total of 81 patients were identified: 54 received HD-MTX (median age 66 years) while 27 received HD-MTX/R (median age 65 years). CR rates were 36% in the HD-MTX cohort and 73% in the HD-MTX/R cohort (p = 0.0145). Median progression-free survival was 4.5 months in the HD-MTX cohort and 26.7 months in the HD-MTX/R cohort (p = 0.003). Median overall survival was 16.3 months in the HD-MTX cohort and has not yet been reached in the HD-MTX/R cohort (p = 0.01). Conclusions: The addition of rituximab to HD-MTX appears to improve CR rates as well as overall and progression-free survival in patients with newly diagnosed PCNSL. Comparisons of long-term survival in the 2 cohorts await further maturation of the data. Classification of evidence: This study provides Class III evidence that in immunocompetent patients with PCNSL, HD-MTX plus rituximab compared with HD-MTX alone improves CR and overall survival rates. |
| Related Links | http://europepmc.org/articles/pmc4117362?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117362/pdf |
| Ending Page | 239 |
| Page Count | 5 |
| Starting Page | 235 |
| e-ISSN | 1526632X |
| DOI | 10.1212/wnl.0000000000000593 |
| Journal | Neurology |
| Issue Number | 3 |
| Volume Number | 83 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2014-07-15 |
| Access Restriction | Open |
| Subject Keyword | Journal: Neurology Gastroenterology and Hepatology Hd Mtx Patients with Newly Diagnosed Newly Diagnosed Pcnsl |
| Content Type | Text |
| Resource Type | Article |
