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Treatment of primary intraocular lymphoma with oral trofosfamide: report of two cases and review of the literature

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Abstract

Background

The prognosis of primary intraocular lymphoma (PIOL) is poor. Due to frequent ocular and/or CNS relapses, the optimal treatment for PIOL has not yet been defined. This is the first report of PIOL treatment with trofosfamide.

Methods

The first patient with a newly diagnosed PIOL was not considered eligible for high-dose methotrexate-based systemic chemotherapy due to comorbidities. The second patient had a primary central nervous system lymphoma, which was resistant to three chemotherapy regimens and responded to whole-brain irradiation. A tumor relapse in the eye was treated with local radiotherapy with initial success; however, the tumor subsequently recurred. The first patient received oral trofosfamide 150 mg daily, the second 400 mg daily (reduced after 5 months of therapy to 300 mg daily) over 5 consecutive days, followed by a 5-day drug-free interval.

Results

In both patients, complete remission was achieved, which lasted for 8+ and 18 months, respectively. Except for a temporary asymptomatic decrease in hemoglobin in the first patient, no toxicity was observed.

Conclusions

Trofosfamide may offer an alternative treatment option for PIOL with a very favorable side effect profile. The exact role of trofosfamide in the treatment of PIOL remains to be defined.

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Authors and Affiliations

  1. Department of Hematology, Oncology and Transfusion Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Kristoph Jahnke, Alexander Schmittel, Lars Fischer, Eckhard Thiel & Agnieszka Korfel

  2. Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Nikolaos E. Bechrakis & Michael H. Foerster

  3. Department of General Pathology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Sarah E. Coupland

Authors
  1. Kristoph Jahnke
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  2. Nikolaos E. Bechrakis
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  3. Sarah E. Coupland
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  4. Alexander Schmittel
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  5. Michael H. Foerster
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  6. Lars Fischer
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  8. Agnieszka Korfel
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Correspondence to Kristoph Jahnke.

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Jahnke, K., Bechrakis, N.E., Coupland, S.E. et al. Treatment of primary intraocular lymphoma with oral trofosfamide: report of two cases and review of the literature. Graefe's Arch Clin Exp Ophthalmol 242, 771–776 (2004). https://doi.org/10.1007/s00417-004-0947-2

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  • DOI: https://doi.org/10.1007/s00417-004-0947-2

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