High-dose chemotherapy with autologous haematopoietic stem cell transplantation in patients with isolated vitreoretinal lymphoma: a LOC network study
Adam Mainguy
(1, 2, 3, 4)
,
Carole Soussain
(5)
,
Valérie Touitou
(1, 2)
,
Amin Bennedjai
(1, 2)
,
Laurent Kodjikian
(6)
,
Hervé Ghesquières
(7)
,
Gandhi Damaj
(8)
,
Rémy Gressin
(9)
,
Jean-Baptiste Ducloyer
(10, 11)
,
Olivier Chinot
(12)
,
Anaïs Vautier
(4)
,
Cécile Moluçon-Chabrot
(13)
,
Guido Ahle
(14)
,
Luc Taillandier
(15)
,
Jean Pierre Marolleau
(16)
,
Adrien Chauchet
(17)
,
Fabrice Jardin
(18)
,
Nathalie Cassoux
(5)
,
Denis Malaise
(5)
,
Adélaïde Toutée
(1, 2)
,
Sara Touhami
(1, 2)
,
Magali Le Garff-Tavernier
(1, 2)
,
Khê Hoang-Xuan
(1, 19)
,
Sylvain Choquet
(1, 2)
,
Caroline Houillier
(1, 19)
1
CHU Pitié-Salpêtrière [AP-HP]
2 SU - Sorbonne Université
3 UA - Université d'Angers
4 CHU Angers - Centre Hospitalier Universitaire d'Angers
5 ICSC - Institut Curie - Saint Cloud
6 Hôpital de la Croix-Rousse [CHU - HCL]
7 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
8 CHU Caen
9 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
10 CIC Nantes - Centre d’Investigation Clinique de Nantes
11 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
12 TIMONE - Hôpital de la Timone [CHU - APHM]
13 Service Hématologie Biologique [CHU Clermont-Ferrand]
14 Hôpitaux Civils de Colmar
15 Service de neurologie [CHRU Nancy]
16 CHU Amiens-Picardie
17 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
18 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
19 ICM - Institut du Cerveau = Paris Brain Institute
2 SU - Sorbonne Université
3 UA - Université d'Angers
4 CHU Angers - Centre Hospitalier Universitaire d'Angers
5 ICSC - Institut Curie - Saint Cloud
6 Hôpital de la Croix-Rousse [CHU - HCL]
7 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
8 CHU Caen
9 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
10 CIC Nantes - Centre d’Investigation Clinique de Nantes
11 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
12 TIMONE - Hôpital de la Timone [CHU - APHM]
13 Service Hématologie Biologique [CHU Clermont-Ferrand]
14 Hôpitaux Civils de Colmar
15 Service de neurologie [CHRU Nancy]
16 CHU Amiens-Picardie
17 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
18 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
19 ICM - Institut du Cerveau = Paris Brain Institute
Adam Mainguy
- Fonction : Auteur
- PersonId : 1446342
- ORCID : 0000-0003-0871-7834
Carole Soussain
- Fonction : Auteur
- PersonId : 1125385
- ORCID : 0000-0002-2479-0348
Rémy Gressin
- Fonction : Auteur
- PersonId : 1446343
- ORCID : 0000-0002-9188-3501
Cécile Moluçon-Chabrot
- Fonction : Auteur
- PersonId : 1446344
- ORCID : 0000-0003-1948-5258
Guido Ahle
- Fonction : Auteur
- PersonId : 1220550
- ORCID : 0000-0002-0877-2289
Denis Malaise
- Fonction : Auteur
- PersonId : 752466
- IdHAL : denis-malaise
- ORCID : 0000-0001-7454-819X
Sylvain Choquet
- Fonction : Auteur
- PersonId : 1202469
- ORCID : 0000-0002-7791-0470
Caroline Houillier
- Fonction : Auteur
- PersonId : 1366182
- ORCID : 0000-0003-2931-7522
Résumé
Despite its indolent evolution, vitreoretinal lymphoma (VRL) has a poor prognosis due to a major risk of relapse in the central nervous system (CNS) and may necessitate aggressive therapy. However, the use of high-dose chemotherapy with autologous stem cell transplantation (HCT-ASCT) is poorly documented. We retrospectively analysed from the French LOC network database the adult immunocompetent patients treated with HCT-ASCT for isolated VRL. Thirty-eight patients underwent consolidation with HCT-ASCT for isolated VRL between 2008 and 2019 after induction chemotherapy. Twenty patients had primary VRL, and 18 had an isolated VRL relapse of a primary CNS lymphoma. Three patients underwent HCT-ASCT in first-line treatment, 24 in second-line treatment, and 11 in subsequent lines. At HCT-ASCT, the median age was 61 years, and the median KPS was 90. Thirty-two patients (84%) received high-dose thiotepa-based HCT. One patient (3%) died from HCT-ASCT toxicity. Nineteen (50%) patients relapsed after HCT-ASCT, including 17 cases occurring in the brain. The median progression-free survival, brain-free survival and overall survival from HCT-ASCT were 96, 113 and 92 months, respectively. HCT-ASCT represents an effective therapeutic strategy for select VRL patients, with a tolerable safety profile. However, the risk of subsequent brain relapse remains significant.