Table 1.
Management of patients with disease recurrence and subsequent outcomes
| Pt | CR1 Duration, mo | Site of First Progression | Second-line Rx | Resp | Third-line Rx | Resp | ASCT | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1 | 41 | Vitreous | R-HD-MTX, i.t. MTX, intravitreal R | CR | – | – | R-BEAM | PD ASCT +8 mo (vitreous) treated with intravitreal R, i.t. R/MTX → CR in remission at 32 mo from 2nd relapse |
| 2 | 10 | Vitreous | Intravitreal MTX | PD | I.t. + intravitreal R | CR | GemBuMel | PD ASCT +11 mo (cerebellum) treated with R-i.t. AC + i.t. R → PD; WBRT 30.6 Gy; posterior fossa boost +9 Gy → CR in remission +33 mo from 2nd relapse |
| 3 | 5 | Vitreous, optic nerve | R-MPV ×3 | PD | – | – | – | Died from PD |
| 5 | 35 | Frontal lobe | R-HD-MTX ×3 | PD | – | – | – | Died from septic shock/multi-organ failure |
| 6 | 40 | Temporoparietal lobe | R-MPV × 5 | CR | – | – | Thiotepa, carmustine, R | In remission ASCT +4 mo |
| 10 | 10 | Leptomeningeal | R-HDAC ×2 + i.t. MTX | PD | R-temozolomide + i.t. MTX | CR | R-BEAM | In remission ASCT +6 mo |
| 11 | 9 | Cerebelluma | R-HD-MTX ×4 | CR | – | – | – | In remission HD-MTX +1 mo |
Abbreviations: Pt, patient; Rx, treatment; MTX, methotrexate; HD, high-dose; R, rituximab; resp, response; PD, progressive disease; BEAM, carmustine, etoposide, cytarabine, melphalan; GemBuMel, gemcitabine, busulfan, melphalan; AC, cytarabine; WBRT, whole brain radiotherapy.
a
Not biopsy proven, as the site of suspected involvement was deemed unsafe for stereotactic biopsy and CSF negative.