IELSG32 second randomisation: whole-brain radiotherapy or autologous stem cell transplant as consolidation in primary CNS lymphoma
After chemotherapy for lymphoma of the brain, a stem cell transplant controlled the disease as well as radiotherapy to the whole brain, and spared patients the decline in attention and executive function that followed radiotherapy.
Overview
Second randomisation of the IELSG32 trial: patients with responsive or stable disease after high-dose methotrexate-based induction were randomised to whole-brain radiotherapy of 36 Gy (with a 9 Gy boost for residual disease) or carmustine-thiotepa conditioning with autologous stem cell transplant. The primary endpoint was two-year progression-free survival.
Two-year failure-free survival in the registry results was 76 percent after radiotherapy and 75 percent after transplant. Neuropsychological testing showed impairment of attention and executive functions after radiotherapy and preserved or improved cognition after transplant.
- Two-year failure-free survival 76 percent (95% CI 65 to 87) after whole-brain radiotherapy and 75 percent (64 to 86) after autologous transplant (registry results).
- Cognitive function was preserved after transplant and impaired in attention and executive domains after radiotherapy.
Autologous transplant is an effective consolidation that avoids the neurotoxicity of whole-brain radiotherapy, and IELSG43 later showed it beats non-myeloablative consolidation.
- Randomised phase 2; only patients fit for transplant and with stem cells collected reached the second randomisation.
Similar pages
not linked directly; found by shared links- Key paperIELSG32 first randomisation: the MATRix regimen (methotrexate, cytarabine, thiotepa, rituximab) in primary CNS lymphoma
Shares The Lancet Haematology, IELSG32, Thiotepa, Primary CNS lymphoma.
- Key paperMATRix/IELSG43: high-dose chemotherapy and autologous stem cell transplant versus non-myeloablative consolidation in primary CNS lymphoma
Shares Carmustine, Thiotepa, Primary CNS lymphoma.
- TrialMATRix/IELSG43
Shares Carmustine, Thiotepa, Primary CNS lymphoma.
- TechnologyAutologous stem cell transplant (high-dose therapy)
Shares IELSG32, Carmustine, Thiotepa, Primary CNS lymphoma.