Successful treatment of AIDS-associated, primary CNS lymphoma with rituximab- and methotrexate-based chemotherapy and autologous stem cell transplantation
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Primary central nervous system lymphoma (PCNSL) is an Epstein–Barr virus (EBV)-associated, acquired immunodeficiency syndrome (AIDS)-defining malignancy. Even in the HAART (highly active antiretroviral therapy) era, in which the survival of patients with PCNSL has improved and the incidence has sharply reduced [1, 2], the median survival time is <6 months . PCNSL has become a rare disease and, consequently, there is no consensus and only anecdotal evidence on the best treatment. Options include high-dose methotrexate (MTX) and radiotherapy.
In the non-human immunodeficiency virus (HIV) setting, sequential high-dose MTX/cytarabin regimens followed by autologous stem cell transplantation (SCT) have been shown to improve 5-year overall survival from 69 to 87 % . The addition of radiation therapy to such regimens, however, was found to be associated with increased neurotoxicity . There is currently no data on the feasibility and efficacy of such protocols in the clinical setting...
KeywordsAutologous Stem Cell Transplantation Primary Central Nervous System Lymphoma BCNU Liposomal Doxorubicin Peripheral Blood Stem Cell Transplantation
Conflict of interest
There was no financial or material support provided for this work. TW had board memberships, received consultancy fees, payment for lectures and travel grants from Abbvie, BMS, Gilead, MSD, Oxford Immunotec and ViiV. HRB had board memberships, received consultancy fees, payment for lectures and travel grants from Gilead, Janssen, MSD, Pfizer and ViiV. CS received consultancy fees from Abbvie, BMS, Boehringer, Gilead, Janssen, MSD, ViiV. JA, GK and CB have no disclosures.
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