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Efficacy and feasibility of autologous stem cell transplantation in patients with diffuse large B-cell lymphoma with secondary central nervous system involvement

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Abstract

Secondary central nervous system (CNS) involvement is a fatal complication of diffuse large B-cell lymphoma (DLBCL). We evaluated the efficacy and feasibility of high-dose chemotherapy containing busulfan and thiotepa followed by autologous stem cell transplantation (HDC-ASCT) in DLBCL with secondary CNS involvement. Thirty-one patients with secondary CNS involvement including CNS involvement at diagnosis (n = 9), isolated CNS relapse (n = 14), and CNS involvement with systemic disease progression or relapse (n = 8) were selected and analyzed from our prospective cohorts. Of these, 12 patients, including seven with isolated CNS relapse, successfully completed HDC-ASCT without engraftment failure or transplantation-related mortality. After ASCT, six patients were alive; however, three patients experienced post-transplantation relapse. With a median follow-up of 29 months after secondary CNS involvement, the median overall survival of 31 patients was 9 months (95 % CI 5–12 months). The survival outcomes of patients who had undergone HDC-ASCT were significantly better than those of patients who did not (p < 0.01). Accordingly, patients with isolated CNS relapse tended to have a longer survival outcome than other cases. Our results suggest that HDC-ASCT may provide survival benefits in DLBCL patients with secondary CNS involvement, especially in case of isolated CNS relapse.

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Acknowledgments

This study was supported by Grants from the Samsung Biomedical Research Institute (GL1B30311), and the National Research Foundation of Korea’s (NRF) Basic Science Research Program (2012R1A1A2008573), which is funded by the Ministry of Education, Science and Technology.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Kangnam-gu, Seoul, 135-710, Korea

    Min-Young Lee, Hae Su Kim, Ji Yun Lee, Sung Hee Lim, Seok Jin Kim & Won Seog Kim

  2. Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Eun Suk Kang

  3. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Young Hyeh Ko

  4. Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea

    Seok Jin Kim

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  1. Min-Young Lee
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Correspondence to Seok Jin Kim.

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Lee, MY., Kim, H.S., Lee, J.Y. et al. Efficacy and feasibility of autologous stem cell transplantation in patients with diffuse large B-cell lymphoma with secondary central nervous system involvement. Int J Hematol 102, 678–688 (2015). https://doi.org/10.1007/s12185-015-1874-1

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  • DOI: https://doi.org/10.1007/s12185-015-1874-1

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