Extending potentially curative options for older patients with PCNSL
Mené en Allemagne sur 54 patients âgés atteints d'un lymphome diffus à grandes cellules B du système nerveux central (âge médian : 71 ans ; durée médiane de suivi : 23 mois), cet essai de phase II évalue l'efficacité, du point de vue de la survie sans progression à 12 mois, et la toxicité d'une chimiothérapie à haute dose et d'une greffe autologue de cellules souches
Substantial progress in the management of patients with primary diffuse large B-cell CNS lymphoma (PCNSL) has been made over recent decades, a rare malignancy that was previously considered incurable. The majority of patients treated with intensive protocols including thiotepa-based high-dose chemotherapy with autologous haematopoietic stem-cell transplantation (HSCT) consolidation can now expect to survive more than 7 years. 1 , 2 However, the median age at presentation for PCNSL is 65 years, therefore many patients are older or have comorbidities, and have often been excluded from prospective trials. Intensive treatment protocols incorporating autologous HSCT have not been prospectively assessed in patients older than 70 years (in some trials, only patients younger than 60 years have been included), and long-term overall survival rates are suboptimal. The MARTA trial, reported in The Lancet Haematology by Elisabeth Schorb and colleagues 4 aimed to address this knowledge gap by assessing intensive chemotherapy and autologous HSCT in patients aged 65–80 years with PCNSL.