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Early response to high-dose methotrexate, vincristine, and procarbazine chemotherapy-adapted strategy for primary CNS lymphoma: no consolidation therapy for patients achieving early complete response.

DC FieldValueLanguage
dc.contributor.author서창옥-
dc.contributor.author장종희-
dc.contributor.author장지은-
dc.contributor.author정준원-
dc.contributor.author현신영-
dc.contributor.author황도유-
dc.contributor.author김세훈-
dc.contributor.author김수정-
dc.contributor.author김유리-
dc.contributor.author김윤덕-
dc.contributor.author김진석-
dc.contributor.author민유홍-
dc.date.accessioned2015-01-06T16:23:52Z-
dc.date.available2015-01-06T16:23:52Z-
dc.date.issued2014-
dc.identifier.issn0939-5555-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/98028-
dc.description.abstractOptimal treatment strategies for primary central nervous system lymphoma (PCNSL) have not been established. In this study, we investigated the treatment outcomes and prognostic factors of high-dose methotrexate, vincristine, and procarbazine (MVP) chemotherapy followed by an interim response-adapted intensification strategy in immunocompetent patients with PCNSL. We evaluated the evidence of infection with Epstein-Barr virus (EBV) in both brain tumor tissue and whole blood. Forty patients were retrospectively reviewed. Ten (25 %) patients who achieved complete response (CR) in the interim analysis did not receive any additional consolidation treatment after completion of planned high-dose MVP chemotherapy. Additional radiotherapy (n = 9) or autologous stem cell transplantation (ASCT) (n = 7) was performed in patients who did not achieve CR in the interim analysis. The median age was 55 years. The overall CR rate was 62.5 % (n = 25), and the objective response rate was 75.0 %. Two-year overall survival (OS) was 59.8 %, and 2-year progression-free survival was 47.1 %. Grade 3 or 4 neutropenia and thrombocytopenia occurred in 47.5 and 32.5 % of patients, respectively. Treatment-related mortality was 15.0 % (n = 6), and four patients developed delayed neurotoxicity. There was no evidence of EBV-encoded RNA expression in brain tumor tissue. Ten (29.4 %) of 34 patients showed detectable EBV-DNA in whole blood. Poor performance status and EBV-DNA positivity in whole blood were significantly associated with inferior OS (p = 0.032, p = 0.023, respectively). We suggest that high-dose MVP chemotherapy followed by an early response-adapted intensification strategy may be effective and minimize the number of patients who receive radiotherapy or ASCT in the early course of treatment.-
dc.description.statementOfResponsibilityopen-
dc.format.extent211~219-
dc.relation.isPartOfANNALS OF HEMATOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAntineoplastic Combined Chemotherapy Protocols/administration & dosage*-
dc.subject.MESHAntineoplastic Combined Chemotherapy Protocols/adverse effects-
dc.subject.MESHAutografts-
dc.subject.MESHBrain Neoplasms/metabolism-
dc.subject.MESHBrain Neoplasms/mortality-
dc.subject.MESHBrain Neoplasms/pathology-
dc.subject.MESHBrain Neoplasms/therapy*-
dc.subject.MESHBrain Neoplasms/virology-
dc.subject.MESHDNA, Viral/metabolism-
dc.subject.MESHDisease-Free Survival-
dc.subject.MESHEpstein-Barr Virus Infections/metabolism-
dc.subject.MESHEpstein-Barr Virus Infections/mortality-
dc.subject.MESHEpstein-Barr Virus Infections/pathology-
dc.subject.MESHEpstein-Barr Virus Infections/therapy*-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHGene Expression Regulation, Neoplastic/drug effects-
dc.subject.MESHGene Expression Regulation, Neoplastic/radiation effects-
dc.subject.MESHGene Expression Regulation, Viral/drug effects-
dc.subject.MESHGene Expression Regulation, Viral/radiation effects-
dc.subject.MESHHerpesvirus 4, Human*-
dc.subject.MESHHumans-
dc.subject.MESHLymphoma/metabolism-
dc.subject.MESHLymphoma/mortality-
dc.subject.MESHLymphoma/pathology-
dc.subject.MESHLymphoma/therapy*-
dc.subject.MESHLymphoma/virology-
dc.subject.MESHMale-
dc.subject.MESHMethotrexate/administration & dosage-
dc.subject.MESHMethotrexate/adverse effects-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProcarbazine/administration & dosage-
dc.subject.MESHProcarbazine/adverse effects-
dc.subject.MESHRNA, Viral/metabolism-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHStem Cell Transplantation*-
dc.subject.MESHSurvival Rate-
dc.subject.MESHVincristine/administration & dosage-
dc.subject.MESHVincristine/adverse effects-
dc.titleEarly response to high-dose methotrexate, vincristine, and procarbazine chemotherapy-adapted strategy for primary CNS lymphoma: no consolidation therapy for patients achieving early complete response.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Neurosurgery (신경외과학)-
dc.contributor.googleauthorYu Ri Kim-
dc.contributor.googleauthorSe Hoon Kim-
dc.contributor.googleauthorJong Hee Chang-
dc.contributor.googleauthorChang-Ok Suh-
dc.contributor.googleauthorSoo-Jeong Kim-
dc.contributor.googleauthorYundeok Kim-
dc.contributor.googleauthorDoh Yu Hwang-
dc.contributor.googleauthorJi Eun Jang-
dc.contributor.googleauthorShin Young Hyun-
dc.contributor.googleauthorJune-Won Cheong-
dc.contributor.googleauthorYoo Hong Min-
dc.contributor.googleauthorJin Seok Kim-
dc.identifier.doi10.1007/s00277-013-1853-7-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01919-
dc.contributor.localIdA03470-
dc.contributor.localIdA03477-
dc.contributor.localIdA03729-
dc.contributor.localIdA04381-
dc.contributor.localIdA04457-
dc.contributor.localIdA00610-
dc.contributor.localIdA00633-
dc.contributor.localIdA00790-
dc.contributor.localIdA01017-
dc.contributor.localIdA01407-
dc.contributor.localIdA00779-
dc.relation.journalcodeJ00161-
dc.identifier.eissn1432-0584-
dc.identifier.pmid23903866-
dc.identifier.urlhttp://link.springer.com/article/10.1007%2Fs00277-013-1853-7-
dc.subject.keywordPrimary central nervous system lymphoma-
dc.subject.keywordHigh-dose methotrexate-
dc.subject.keywordConsolidation-
dc.subject.keywordComplete response-
dc.subject.keywordEpstein-Barr virus-
dc.contributor.alternativeNameSuh, Chang Ok-
dc.contributor.alternativeNameChang, Jong Hee-
dc.contributor.alternativeNameJang, Ji Eun-
dc.contributor.alternativeNameCheong, June Won-
dc.contributor.alternativeNameHyun, Shin Yong-
dc.contributor.alternativeNameHwang, Doh Yu-
dc.contributor.alternativeNameKim, Se Hoon-
dc.contributor.alternativeNameKim, Soo Jeong-
dc.contributor.alternativeNameKim, Yu Ri-
dc.contributor.alternativeNameKim, Yun Deok-
dc.contributor.alternativeNameKim, Jin Seok-
dc.contributor.alternativeNameMin, Yoo Hong-
dc.contributor.affiliatedAuthorSuh, Chang Ok-
dc.contributor.affiliatedAuthorChang, Jong Hee-
dc.contributor.affiliatedAuthorJang, Ji Eun-
dc.contributor.affiliatedAuthorCheong, June-Won-
dc.contributor.affiliatedAuthorHyun, Shin Yong-
dc.contributor.affiliatedAuthorHwang, Doh Yu-
dc.contributor.affiliatedAuthorKim, Se Hoon-
dc.contributor.affiliatedAuthorKim, Soo Jeong-
dc.contributor.affiliatedAuthorKim, Yun Deok-
dc.contributor.affiliatedAuthorKim, Jin Seok-
dc.contributor.affiliatedAuthorMin, Yoo Hong-
dc.contributor.affiliatedAuthorKim, Yu Ri-
dc.rights.accessRightsfree-
dc.citation.volume93-
dc.citation.number2-
dc.citation.startPage211-
dc.citation.endPage219-
dc.identifier.bibliographicCitationANNALS OF HEMATOLOGY, Vol.93(2) : 211-219, 2014-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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