High-dose chemotherapy with autologous haematopoietic stem cell transplantation in patients with isolated vitreoretinal lymphoma: a LOC network study

Despite its indolent evolution, vitreoretinal lymphoma (VRL) has a poor prognosis due to a major risk of relapse in the central nervous system (CNS) and may necessitate aggressive therapy. However, the use of high-dose chemotherapy with autologous stem cell transplantation (HCT-ASCT) is poorly documented. We retrospectively analysed from the French LOC network database the adult immunocompetent patients treated with HCT-ASCT for isolated VRL. Thirty-eight patients underwent consolidation with HCT-ASCT for isolated VRL between 2008 and 2019 after induction chemotherapy. Twenty patients had primary VRL, and 18 had an isolated VRL relapse of a primary CNS lymphoma. Three patients underwent HCT-ASCT in first-line treatment, 24 in second-line treatment, and 11 in subsequent lines. At HCT-ASCT, the median age was 61 years, and the median KPS was 90. Thirty-two patients (84%) received high-dose thiotepa-based HCT. One patient (3%) died from HCT-ASCT toxicity. Nineteen (50%) patients relapsed after HCT-ASCT, including 17 cases occurring in the brain. The median progression-free survival, brain-free survival and overall survival from HCT-ASCT were 96, 113 and 92 months, respectively. HCT-ASCT represents an effective therapeutic strategy for select VRL patients, with a tolerable safety profile. However, the risk of subsequent brain relapse remains significant.

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Publication Details

Journal
Bone Marrow Transplantation
Published
2024-11-19
DOI
https://doi.org/10.1038/s41409-024-02477-y
Citations
3
Primary Topic
CNS Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
1.11

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article

High-dose chemotherapy with autologous haematopoietic stem cell transplantation in patients with isolated vitreoretinal lymphoma: a LOC network study

Guido Ahle, Khê Hoang‐Xuan, Denis Malaise, Nathalie Cassoux et al.
3 citations
Bone Marrow Transplantation
CNS Lymphoma Diagnosis and Treatment
1.11
article

High-dose chemotherapy with autologous haematopoietic stem cell transplantation in patients with isolated vitreoretinal lymphoma: a LOC network study

Guido Ahle, Khê Hoang‐Xuan, Denis Malaise, Nathalie Cassoux, Sylvain Choquet, Anaïs Vautier, Sara Touhami, Cécile Moluçon‐Chabrot, Valérie Touitou, Adélaïde Toutée, Luc Taillandier, Adrien Chauchet, Carole Soussain, Laurent Kodjikian, Magali Le Garff‐Tavernier, A. Mainguy, Amin Bennedjaï, Jean‐Baptiste Ducloyer, Gandhi Laurent Damaj, Rémy Gressin, Olivier Chinot, Hervé Ghesquières, Fabrice Jardin, Caroline Houillier, Jean Pierre Marolleau
article en
3 citations

Abstract

Despite its indolent evolution, vitreoretinal lymphoma (VRL) has a poor prognosis due to a major risk of relapse in the central nervous system (CNS) and may necessitate aggressive therapy. However, the use of high-dose chemotherapy with autologous stem cell transplantation (HCT-ASCT) is poorly documented. We retrospectively analysed from the French LOC network database the adult immunocompetent patients treated with HCT-ASCT for isolated VRL. Thirty-eight patients underwent consolidation with HCT-ASCT for isolated VRL between 2008 and 2019 after induction chemotherapy. Twenty patients had primary VRL, and 18 had an isolated VRL relapse of a primary CNS lymphoma. Three patients underwent HCT-ASCT in first-line treatment, 24 in second-line treatment, and 11 in subsequent lines. At HCT-ASCT, the median age was 61 years, and the median KPS was 90. Thirty-two patients (84%) received high-dose thiotepa-based HCT. One patient (3%) died from HCT-ASCT toxicity. Nineteen (50%) patients relapsed after HCT-ASCT, including 17 cases occurring in the brain. The median progression-free survival, brain-free survival and overall survival from HCT-ASCT were 96, 113 and 92 months, respectively. HCT-ASCT represents an effective therapeutic strategy for select VRL patients, with a tolerable safety profile. However, the risk of subsequent brain relapse remains significant.

Bone Marrow TransplantationVol. 60(3)
Centre National de la Recherche Scientifique (FR), Inserm (FR), Centre Hospitalier Universitaire de Grenoble (FR), Centre Hospitalier Universitaire de Nantes (FR), Sorbonne Université (FR), Assistance Publique Hôpitaux de Marseille (FR), Centre Hospitalier Universitaire de Besançon (FR), Hôpital de la Croix-Rousse (FR), Hopitaux Civils de Colmar (FR), Centre Hospitalier Universitaire Amiens-Picardie (FR), Assistance Publique – Hôpitaux de Paris (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Hospices Civils de Lyon (FR), Centre Hospitalier Universitaire d'Angers (FR), Hôpital Lyon Sud (FR), Centre Hospitalier Universitaire de Caen Normandie (FR), Pitié-Salpêtrière Hospital (FR), Centre d'Investigation Clinique de Nantes (FR), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Centre Virchow-Villermé (FR), Institut du Cerveau (FR), Hôpital de la Timone (FR), Centre Henri Becquerel (FR), Université de Picardie Jules Verne (FR), Université d'Angers (FR), Institut Curie (FR), Université Grenoble Alpes (FR), Université de Caen Normandie (FR)
Institut National Du Cancer
Good health and well-being
Openalex Percentile: Top 20%
CNS Lymphoma Diagnosis and Treatment
1.11
DOIOpen Access PDFOpenAlex
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