Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study
Primary central nervous system lymphoma is a rare but aggressive brain malignancy. It is associated with poor prognosis even with the current standard of care. The aim of this study was to evaluate the effect and tolerability of blood–brain barrier disruption treatment combined with high-dose treatm...
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/4/1341 |
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| author | Hanne K. Kuitunen Aino L. K. Rönkä Eila M. Sonkajärvi Juha-Matti Isokangas Marja Pyörälä Kari A. A. Palosaari Anna S. Jokimäki Anu E. Partanen Harri J. Littow Merja A. Vakkala Esa J. Jantunen Mirja E. Huttunen Katja J. Marin Annikki M. K. Aromaa-Häyhä Päivi K. Auvinen Tuomas Selander Inka K. Puhakka Outi M. Kuittinen |
| author_facet | Hanne K. Kuitunen Aino L. K. Rönkä Eila M. Sonkajärvi Juha-Matti Isokangas Marja Pyörälä Kari A. A. Palosaari Anna S. Jokimäki Anu E. Partanen Harri J. Littow Merja A. Vakkala Esa J. Jantunen Mirja E. Huttunen Katja J. Marin Annikki M. K. Aromaa-Häyhä Päivi K. Auvinen Tuomas Selander Inka K. Puhakka Outi M. Kuittinen |
| author_sort | Hanne K. Kuitunen |
| collection | DOAJ |
| description | Primary central nervous system lymphoma is a rare but aggressive brain malignancy. It is associated with poor prognosis even with the current standard of care. The aim of this study was to evaluate the effect and tolerability of blood–brain barrier disruption treatment combined with high-dose treatment with autologous stem cell transplantation as consolidation on primary central nervous system lymphoma patients. We performed a prospective phase II study for 25 patients with previously untreated primary central nervous system lymphoma. The blood–brain barrier disruption treatment was initiated 3–4 weeks after the MATRix regimen using the previously optimized therapy protocol. Briefly, each chemotherapy cycle included two subsequent intra-arterial blood–brain barrier disruption treatments on days 1 and 2 via either one of the internal carotid arteries or vertebral arteries. Patients received the therapy in 3-week intervals. The treatment was continued for two more courses after achieving a maximal radiological response to the maximum of six courses. The complete treatment response was observed in 88.0% of the patients. At the median follow-up time of 30 months, median progression-free and overall survivals were not reached. The 2-year overall and progression-free survival rates were 67.1% and 70.3%, respectively. Blood–brain barrier disruption treatment is a promising option for primary central nervous system lymphoma with an acceptable toxicity profile. |
| first_indexed | 2024-03-11T09:02:13Z |
| format | Article |
| id | doaj.art-abc7b1b4382f4629a7de50373877556a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T09:02:13Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-abc7b1b4382f4629a7de50373877556a2023-11-16T19:39:39ZengMDPI AGCancers2072-66942023-02-01154134110.3390/cancers15041341Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II StudyHanne K. Kuitunen0Aino L. K. Rönkä1Eila M. Sonkajärvi2Juha-Matti Isokangas3Marja Pyörälä4Kari A. A. Palosaari5Anna S. Jokimäki6Anu E. Partanen7Harri J. Littow8Merja A. Vakkala9Esa J. Jantunen10Mirja E. Huttunen11Katja J. Marin12Annikki M. K. Aromaa-Häyhä13Päivi K. Auvinen14Tuomas Selander15Inka K. Puhakka16Outi M. Kuittinen17Cancer Center, Oulu University Hospital, 90220 Oulu, FinlandDepartment of Oncology and Radiotherapy, Kuopio University Hospital, 70210 Kuopio, FinlandSurgery and Anaesthesia Center, Oulu University Hospital, 90220 Oulu, FinlandService for Medical Care, Oulu University Hospital Diagnostics, 90220 Oulu, FinlandDepartment of Medicine, Kuopio University Hospital, 70210 Kuopio, FinlandService for Medical Care, Oulu University Hospital Diagnostics, 90220 Oulu, FinlandCancer Center, Oulu University Hospital, 90220 Oulu, FinlandDepartment of Medicine, Kuopio University Hospital, 70210 Kuopio, FinlandService for Medical Care, Oulu University Hospital Diagnostics, 90220 Oulu, FinlandSurgery and Anaesthesia Center, Oulu University Hospital, 90220 Oulu, FinlandDepartment of Medicine, Kuopio University Hospital, 70210 Kuopio, FinlandSurgery and Anaesthesia Center, Oulu University Hospital, 90220 Oulu, FinlandDepartment of Oncology and Radiotherapy, Kuopio University Hospital, 70210 Kuopio, FinlandDepartment of Oncology and Radiotherapy, Kuopio University Hospital, 70210 Kuopio, FinlandDepartment of Oncology and Radiotherapy, Kuopio University Hospital, 70210 Kuopio, FinlandScience Service Center, Kuopio University Hospital, 70210 Kuopio, FinlandDepartment of Neurology, Kuopio University Hospital, 70210 Kuopio, FinlandDepartment of Oncology and Radiotherapy, Kuopio University Hospital, 70210 Kuopio, FinlandPrimary central nervous system lymphoma is a rare but aggressive brain malignancy. It is associated with poor prognosis even with the current standard of care. The aim of this study was to evaluate the effect and tolerability of blood–brain barrier disruption treatment combined with high-dose treatment with autologous stem cell transplantation as consolidation on primary central nervous system lymphoma patients. We performed a prospective phase II study for 25 patients with previously untreated primary central nervous system lymphoma. The blood–brain barrier disruption treatment was initiated 3–4 weeks after the MATRix regimen using the previously optimized therapy protocol. Briefly, each chemotherapy cycle included two subsequent intra-arterial blood–brain barrier disruption treatments on days 1 and 2 via either one of the internal carotid arteries or vertebral arteries. Patients received the therapy in 3-week intervals. The treatment was continued for two more courses after achieving a maximal radiological response to the maximum of six courses. The complete treatment response was observed in 88.0% of the patients. At the median follow-up time of 30 months, median progression-free and overall survivals were not reached. The 2-year overall and progression-free survival rates were 67.1% and 70.3%, respectively. Blood–brain barrier disruption treatment is a promising option for primary central nervous system lymphoma with an acceptable toxicity profile.https://www.mdpi.com/2072-6694/15/4/1341BBBDPCNSLASCT |
| spellingShingle | Hanne K. Kuitunen Aino L. K. Rönkä Eila M. Sonkajärvi Juha-Matti Isokangas Marja Pyörälä Kari A. A. Palosaari Anna S. Jokimäki Anu E. Partanen Harri J. Littow Merja A. Vakkala Esa J. Jantunen Mirja E. Huttunen Katja J. Marin Annikki M. K. Aromaa-Häyhä Päivi K. Auvinen Tuomas Selander Inka K. Puhakka Outi M. Kuittinen Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study Cancers BBBD PCNSL ASCT |
| title | Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study |
| title_full | Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study |
| title_fullStr | Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study |
| title_full_unstemmed | Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study |
| title_short | Blood–Brain Barrier Disruption (BBBD)-Based Immunochemotherapy for Primary Central Nervous System Lymphoma (PCNSL), Early Results of a Phase II Study |
| title_sort | blood brain barrier disruption bbbd based immunochemotherapy for primary central nervous system lymphoma pcnsl early results of a phase ii study |
| topic | BBBD PCNSL ASCT |
| url | https://www.mdpi.com/2072-6694/15/4/1341 |
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