Retrospective study of a rituximab, methotrexate, and thiotepa-based regimen in newly diagnosed primary CNS lymphoma

The optimal first-line induction strategy for patients with primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is not known. A retrospective study at the First Hospital of Jilin University (Jilin, China) evaluated efficacy and safety of a rituximab, methotrexate, and thiotepa (RMT)-based regimen for newly diagnosed PNCS-DLBCL patients. Thirty-six patients received 4-6 cycles of RMT. After 4 induction cycles, the overall response rate was 97.2% and the complete response rate was 80.6%. With a median follow-up of 19.9 months, the 2-year progression-free survival (PFS) and overall survival (OS) rates were 64.4% and 79.3%, respectively. The 2-year PFS rate was 100% in patients receiving sequential autologous stem cell transplatnation, 67.9% with maintenance therapy (BTKi/iMiD), and 45.5% with induction only. The most common grade 3-4 adverse event was neutropenia (33.3%) which was manageable without treatment discontinuation. The authors conclude that the RMT demonstrated excellent efficacy and a favorable safety profile in PNCS-DLBCL (graphical abstract).