Relapsed or Refractory Primary CNS Lymphoma When Salvage Chemotherapy Fails to Achieve Response

Clinical scenario

This protocol applies to fit patients with relapsed or refractory primary CNS lymphoma — including those with refractory disease or early relapse — who are candidates for salvage polychemotherapy.

Previous treatment & failure condition

The preceding line consisted of salvage chemotherapy with HD-cytarabine-based or HD-ifosfamide-based combinations. Escalation to the present protocol is triggered when that treatment fails to achieve the goal of complete remission or partial response on brain MRI.

Next step — partial overview

For fit patients who do achieve a response to salvage chemotherapy, the next phase involves a consolidation strategy — either autologous stem cell transplantation or whole-brain radiotherapy — selected on the basis of what was used in the first-line setting.

Full regimen, sequencing, and selection criteria available via the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2023.11.010

Fit patients with refractory or early relapsed PCNSL can be treated with, for example, HD-ifosfamide- or HD-AraC-based combinations, followed by ASCT or WBRT according to previous treatment.

HD-AraC- or HD-ifosfamide-based ChT followed by consolidative HDCeASCT is an option for fit patients.

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