Frontiers in Oncology (Jan 2024)

Case report: Successful treatment of a patient with relapsed/refractory primary central nervous system lymphoma with thiotepa-based induction, autologous stem cell transplantation and maintenance

  • Luyao Wang,
  • Yili Fan,
  • Boxiao Chen,
  • Jiawei Zhang,
  • Luyu Yang,
  • Xi Qiu,
  • Huawei Jiang,
  • Jinfan Li,
  • Xibin Xiao,
  • Liansheng Huang,
  • Yang Xu

DOI
https://doi.org/10.3389/fonc.2023.1333761
Journal volume & issue
Vol. 13

Abstract

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Despite significant improvements in prognosis, a subset of patients with primary central nervous system lymphoma (PCNSL) remains at high risk for relapse. The treatment of relapsed and refractory (R/R) PCNSL remains a major clinical challenge. Herein, we present a 24-year-old patient with PCNSL who relapsed 4 years after initial diagnosis and subsequently became refractory to high-dose methotrexate (HD-MTX), temozolomide, whole brain radiation therapy (WBRT), ibrutinib, and lenalidomide. She received thiotepa with anti-programmed cell death protein 1 (PD-1) antibody and achieved partial remission and then underwent autologous stem cell transplantation (ASCT) with thiotepa-based conditioning. Post-transplant maintenance with thiotepa and anti-PD-1 at 3-month intervals resulted in a durable complete response (CR) in this case of R/R PCNSL. Our report highlights the important role of thiotepa in the treatment of patients with R/R PCNSL.

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