Primary Vitreoretinal Lymphoma: Consolidation After Response to HD-MTX-Based Induction

This protocol applies to patients with primary vitreoretinal lymphoma (PVRL) — lymphoma confined to the eye, with vitreous and/or retinal involvement — who are in good clinical condition with no major comorbidities and have achieved a response to prior induction chemotherapy.

Clinical Scenario

Disease is limited to the eye (vitreous and/or retinal involvement). Comprehensive staging has excluded systemic organ involvement and CNS localisations beyond the eye. The patient has no major comorbidities and is in good clinical condition.

Prior Treatment Line

The preceding step was HD-MTX-based induction chemotherapy, with intravitreal methotrexate injections used where rapid regression of intraocular disease was needed. The clinical goal of that step — achieving complete remission or partial response of intraocular disease — was met, making this consolidation protocol the appropriate next step.

Consolidation Approach

For patients who responded to induction, consolidation involves a targeted radiation strategy directed at the affected ocular structures. The full protocol also addresses a further consolidation option that may be considered and discussed with selected patients.

The complete regimen — including all options, eligibility criteria, and clinical guidance — is available via the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

If comprehensive staging (see below) excludes the involvement of systemic organs and CNS localisations other than the eye, a diagnosis of primary vitreoretinal lymphoma (PVRL) should be considered.

Patients with no major comorbidities and good clinical condition.

Patients with a CR or partial response to HD-MTX-based induction ChT can be eligible for consolidation with low-dose bilateral ocular RT. The risks and benefits of consolidation with ASCT can be discussed with selected patients.

DOI: 10.1016/j.annonc.2023.11.010

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