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After chemotherapy for lymphoma of the brain, a stem cell transplant controlled the disease as well as radiotherapy to the whole brain, and spared patients the decline in attention and executive function that followed radiotherapy.
Second randomisation of the IELSG32 trial: patients with responsive or stable disease after high-dose methotrexate-based induction were randomised to whole-brain radiotherapy of 36 Gy (with a 9 Gy boost for residual disease) or carmustine-thiotepa conditioning with autologous stem cell transplant. The primary endpoint was two-year progression-free survival.
Two-year failure-free survival in the registry results was 76 percent after radiotherapy and 75 percent after transplant. Neuropsychological testing showed impairment of attention and executive functions after radiotherapy and preserved or improved cognition after transplant.
Autologous transplant is an effective consolidation that avoids the neurotoxicity of whole-brain radiotherapy, and IELSG43 later showed it beats non-myeloablative consolidation.
Shares The Lancet Haematology, IELSG32, Thiotepa, Primary CNS lymphoma.
Shares Carmustine, Thiotepa, Primary CNS lymphoma.
Shares IELSG32, Carmustine, Thiotepa, Primary CNS lymphoma.
Shares IELSG32, Primary CNS lymphoma.
Shares Carmustine, Thiotepa, Primary CNS lymphoma.
Shares IELSG32, Carmustine, Thiotepa, Primary CNS lymphoma.