Rituximab, Methotrexate, Carmustine, Etoposide, and Prednisone (RMBVP) for the treatment of relapsed/refractory primary central nervous system lymphoma: a retrospective single-center study

• Published in: Leukemia & lymphoma Vol. 63; no. 3; pp. 627 - 632
• Main Authors: Reiss, Samantha N., Yerram, Prakirthi, Modelevsky, Lisa, Grommes, Christian
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 23.02.2022
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Carmustine - therapeutic use; Central Nervous System - pathology; Central Nervous System Neoplasms - diagnosis; Central Nervous System Neoplasms - drug therapy; chemotherapeutic approaches; Etoposide - adverse effects; Female; Humans; Lymphoma and Hodgkin disease; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - etiology; Methotrexate - therapeutic use; Neoplasm Recurrence, Local - pathology; pharmacotherapeutics; Prednisone - adverse effects; Retrospective Studies; Rituximab; chemotherapeutic approaches; pharmacotherapeutics; Lymphoma and Hodgkin disease
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2021.1998481

Relapsed/refractory Primary Central Nervous System Lymphoma (R/R PCNSL) has a poor prognosis with no established preferred treatment. We report the efficacy and toxicity of a combination chemotherapy regimen: methotrexate, carmustine, etoposide, and prednisone with or without rituximab (RMBVP). This retrospective study included thirty patients who received a median of two 28-day cycles (0.5-5). The median age was 66 years (23-81); median KPS was 70 (30-90); 14 (46.7%) were women. Patients received a median of 2 prior lines of therapy and all received prior methotrexate. Of 29 evaluable patients, the overall response rate was 73.3% (n = 22). Median progression-free survival (PFS) was 15.6 months. Patients who recurred or progressed <12 months since last chemotherapy had a shorter median PFS (7.6 vs 37.6 months). Toxicity was moderate with 20% rates of severe myelosuppression. RMBVP is a tolerable treatment option for R/R PCNSL, with favorable response rates in those with recurrent disease.