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Background <p>Secondary Central Nervous Lymphoma (SCNSL) is an aggressive lymphoma with poor outcomes. Consensus regarding consolidation with thiotepa-based autologous transplant (ASCT) for SCNSL is lacking.</p> Methods <p>Our retrospective Singapore study examined survival outcomes post ASCT in 27 patients (median age 57 years) with SCNSL in two tertiary cancer centres from 2013 to 2024.</p> Results <p>Five (18.5%) patients had <i>de novo</i> SCNSL, 14 (51.9%) patients had isolated CNS relapsed SCNSL and 8 (29.6%) patients had synchronous relapsed SCNSL. At the time of ASCT, 16 (59.3%), 7 (25.9%) and 4 (14.8%) patients were in CR, PR and SD/PD respectively. Median follow up for the 22 relapsed SCNSL patients was 63 (5–109) months with a median PFS and OS of 11.5 and 30 months, respectively, and 4-year PFS and OS rates of 35.0% and 48.0%, respectively. In our analysis, females demonstrated superior median and 4-year PFS and OS compared to males, likely related to difference in age and performance status. On multivariate analysis, CR/PR at time of ASCT trended toward an improved OS (HR 7.86, <i>p</i> = 0.06) although this was not statistically significant.</p> Conclusion <p>Our data suggests that in secondary CNSL, chemo-sensitivity would likely confer good outcomes with thiotepa-based consolidation ASCT. Conversely, patients responding poorly to salvage chemotherapy may consider alternatives including CAR-T cell therapy.</p>

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Autologous stem cell transplantation for secondary central nervous system lymphoma: a multicentre retrospective analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月14日

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  • Meredith W Tan,
  • Victor Ling,
  • Jing Yuan Tan,
  • Wee Lee Chan,
  • Edwin Thong,
  • Chandramouli Nagarajan,
  • Shin Yeu Ong,
  • Yunxin Chen,
  • Francesca LWI Lim,
  • Yeow Tee Goh,
  • William YK Hwang,
  • Aloysius YL Ho,
  • Liang-Piu Koh,
  • Lip Kun Tan,
  • Joanne Lee,
  • Esther HL Chan,
  • Sanjay de Mel,
  • Michelle LM Poon,
  • Lawrence CK Ng

摘要

Background

Secondary Central Nervous Lymphoma (SCNSL) is an aggressive lymphoma with poor outcomes. Consensus regarding consolidation with thiotepa-based autologous transplant (ASCT) for SCNSL is lacking.

Methods

Our retrospective Singapore study examined survival outcomes post ASCT in 27 patients (median age 57 years) with SCNSL in two tertiary cancer centres from 2013 to 2024.

Results

Five (18.5%) patients had de novo SCNSL, 14 (51.9%) patients had isolated CNS relapsed SCNSL and 8 (29.6%) patients had synchronous relapsed SCNSL. At the time of ASCT, 16 (59.3%), 7 (25.9%) and 4 (14.8%) patients were in CR, PR and SD/PD respectively. Median follow up for the 22 relapsed SCNSL patients was 63 (5–109) months with a median PFS and OS of 11.5 and 30 months, respectively, and 4-year PFS and OS rates of 35.0% and 48.0%, respectively. In our analysis, females demonstrated superior median and 4-year PFS and OS compared to males, likely related to difference in age and performance status. On multivariate analysis, CR/PR at time of ASCT trended toward an improved OS (HR 7.86, p = 0.06) although this was not statistically significant.

Conclusion

Our data suggests that in secondary CNSL, chemo-sensitivity would likely confer good outcomes with thiotepa-based consolidation ASCT. Conversely, patients responding poorly to salvage chemotherapy may consider alternatives including CAR-T cell therapy.