Abstract:

The effects of autologous hematopoietic stem cell transplantation(ASCT) in the whole treatment process remain to be unknown to abundant physicians due to low incidence of primary central nervous system lymphoma(PCNSL). Induction therapy based on high-dose methotrexate(HD-MTX) has significantly improved the early control rate of PCNSL, and many patients receive insufficiently thorough remission. Large-scale international clinical studies show that the rate of complete remission(CR) is less than 50% in most case; while the duration of remission remain short and recur within one year. ASCT, a consolidation therapeutic strategy, is applied to primary or relapsed and refractory PCNSL, significantly improved the rate of complete remission and long-term disease-free survival(PFS); the long-term PFS of newly treated PCNSL patients can hit 70%, and that of relapsed and refractory PCNSL patients can hit 50%. Current clinical practices confirmed that PCNSL is more common in older patients. Elderly PCNSL patients with great organ functions remained to tolerate ASCT, significant benefited from ASCT. High-dose thiotepa is preferred for ASCT conditioning regimen of PCNSL, and TBC regimen with stronger conditioning intensity is patients for young patients with better physical conditioning failing reciveing CR after early induction therapy; Older patients are supported to choose TT-BCNU or reduced TBC conditioning regimen.

Key words: neurolymphomatosis, autologous hematopoietic stem cell transplantation, response, survival