Abstract
Purpose: Over the past decade, high-dose methotrexate has emerged as the single most effective agent in the initial treatment of primary nervous system lymphoma. However, the majority of patients who respond initially to treatment relapse. The optimal management of these patients has not been determined. We performed a multicenter, retrospective study of high-dose methotrexate in patients with relapsed central nervous system lymphoma. Experimental Design: Patients with relapsed disease were eligible if they achieved a complete response to initial treatment with methotrexate-based chemotherapy or received methotrexate after gross total resection of interstitial radiation. All of the patients were retreated with a regimen containing high-dose methotrexate (≥3 g/m2). Results: Twenty-two patients with a median age of 58 years were included in the study. Overall response rates were 91% to first salvage (20 of 22 patients) and 100% to second salvage (4 of 4 patients). Median survival was 61.9 months after first relapse (95% confidence interval, 42.1-∞) and 91.9 months overall (95% confidence interval, 47.2-∞). Toxicity was primarily hematologic with 10 episodes of grade 3 or 4 toxicity during 566 cycles of chemotherapy. Conclusions: These results indicate that high-dose methotrexate remains effective for relapsed central nervous system lymphoma in patients who initially respond to methotrexate and raise the possibility of deferring more toxic salvage regimens in this select group of patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 5643-5646 |
| Number of pages | 4 |
| Journal | Clinical Cancer Research |
| Volume | 10 |
| Issue number | 17 |
| DOIs | |
| State | Published - Sep 1 2004 |
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ASJC Scopus subject areas
- Oncology
- Cancer Research
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Treatment of relapsed central nervous system lymphoma with high-dose methotrexate. / Plotkin, Scott R.; Betensky, Rebecca; Hochberg, Fred H.; Grossman, Stuart A.; Lesser, Glenn J.; Nabors, L. Burt; Chon, Brian; Batchelor, Tracy T.
In: Clinical Cancer Research, Vol. 10, No. 17, 01.09.2004, p. 5643-5646.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Treatment of relapsed central nervous system lymphoma with high-dose methotrexate
AU - Plotkin, Scott R.
AU - Betensky, Rebecca
AU - Hochberg, Fred H.
AU - Grossman, Stuart A.
AU - Lesser, Glenn J.
AU - Nabors, L. Burt
AU - Chon, Brian
AU - Batchelor, Tracy T.
PY - 2004/9/1
Y1 - 2004/9/1
N2 - Purpose: Over the past decade, high-dose methotrexate has emerged as the single most effective agent in the initial treatment of primary nervous system lymphoma. However, the majority of patients who respond initially to treatment relapse. The optimal management of these patients has not been determined. We performed a multicenter, retrospective study of high-dose methotrexate in patients with relapsed central nervous system lymphoma. Experimental Design: Patients with relapsed disease were eligible if they achieved a complete response to initial treatment with methotrexate-based chemotherapy or received methotrexate after gross total resection of interstitial radiation. All of the patients were retreated with a regimen containing high-dose methotrexate (≥3 g/m2). Results: Twenty-two patients with a median age of 58 years were included in the study. Overall response rates were 91% to first salvage (20 of 22 patients) and 100% to second salvage (4 of 4 patients). Median survival was 61.9 months after first relapse (95% confidence interval, 42.1-∞) and 91.9 months overall (95% confidence interval, 47.2-∞). Toxicity was primarily hematologic with 10 episodes of grade 3 or 4 toxicity during 566 cycles of chemotherapy. Conclusions: These results indicate that high-dose methotrexate remains effective for relapsed central nervous system lymphoma in patients who initially respond to methotrexate and raise the possibility of deferring more toxic salvage regimens in this select group of patients.
AB - Purpose: Over the past decade, high-dose methotrexate has emerged as the single most effective agent in the initial treatment of primary nervous system lymphoma. However, the majority of patients who respond initially to treatment relapse. The optimal management of these patients has not been determined. We performed a multicenter, retrospective study of high-dose methotrexate in patients with relapsed central nervous system lymphoma. Experimental Design: Patients with relapsed disease were eligible if they achieved a complete response to initial treatment with methotrexate-based chemotherapy or received methotrexate after gross total resection of interstitial radiation. All of the patients were retreated with a regimen containing high-dose methotrexate (≥3 g/m2). Results: Twenty-two patients with a median age of 58 years were included in the study. Overall response rates were 91% to first salvage (20 of 22 patients) and 100% to second salvage (4 of 4 patients). Median survival was 61.9 months after first relapse (95% confidence interval, 42.1-∞) and 91.9 months overall (95% confidence interval, 47.2-∞). Toxicity was primarily hematologic with 10 episodes of grade 3 or 4 toxicity during 566 cycles of chemotherapy. Conclusions: These results indicate that high-dose methotrexate remains effective for relapsed central nervous system lymphoma in patients who initially respond to methotrexate and raise the possibility of deferring more toxic salvage regimens in this select group of patients.
UR - http://www.scopus.com/inward/record.url?scp=4444269516&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4444269516&partnerID=8YFLogxK
U2 - 10.1158/1078-0432.CCR-04-0159
DO - 10.1158/1078-0432.CCR-04-0159
M3 - Review article
C2 - 15355887
AN - SCOPUS:4444269516
VL - 10
SP - 5643
EP - 5646
JO - Clinical Cancer Research
JF - Clinical Cancer Research
SN - 1078-0432
IS - 17
ER -