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TBC-Conditioned ASCT Improves Survival, But…
Biol Blood Marrow Transplant; ePub 2016 Oct 3; Scordo, et al
Thiotepa, busulfan, cyclophosphamide (TBC)-conditioned autologous stem cell transplantation (ASCT) improved progression-free and overall survival in people with central nervous system (CNS) lymphoma, but it came at the price of high toxicity in a study involving 43 individuals.
Participants had primary or secondary CNS lymphoma, and received the regimen between 2006 and 2015. 28 patients were given pharmacokinetically-targeted busulfan dosing. Among the results:
- There was a median of 5 grade 3 or higher non-hematologic toxicities per patient.
- There was no link between patient characteristics and non-hematologic toxicities.
- Patients with elevated first-dose busulfan area under the curve (AUC) levels did not experience more toxicity.
- Those given >2 regimens prior to ASCT had lower first-dose busulfan AUC.
- At a median 20-month follow-up among survivors, 1-year progression-free survival was 84%; overall survival was 87%.
Scordo M, Bhatt V, Hsu M, et al. A comprehensive assessment of toxicities in patients with CNS lymphoma undergoing autologous stem cell transplantation using thiotepa, busulfan and cyclophosphamide conditioning. [Published online ahead of print October 3, 2016]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2016.09.024.