Efficacy of rituximab combined with chemotherapy regimen for the treatment of primary central nervous system lymphomas

Objective To evaluate the effectiveness and safety of rituximab combined with high-dose methotrexate, dexamethasone and dexamethasone (R-MAD regimen) for the treatment of patients with primary central nervous system lymphoma (PCNSL). Methods The clinical data of 35 patients with PCNSL treated at the Department of Hematology, Beijing Tiantan Hospital from January 2010 to June 2015 were analyzed retrospectively. All patients received rituximab (d0:375 mg/m2), high-dose methotrexate (d1:3.5g/m2), cytarabine (d2:0.5-1 g/m2), and dexamethasone (d1-3:10 mg/d) for chemotherapy. Every 21 days were as a course of treatment, and they were treated for 4-6 courses. Results The median follow-up time of 35 patients was 36 (6-66) months, 20 (57.1%) of them achieved complete remission, 13 (37.1%) achieved partial remission, and 2 (5.7%) had progression of disease. The total effective rate was 94.2% (33/35). The median survival time was 38.3 months (95% confidence interval [CI] 19.4-57.2), and the median progression-free survival was 30.0 months (95% CI 9.4-50.6). The adverse reaction of chemotherapy was mainly bone marrow suppression. Twenty-four patients experienced grade 1 to 3 neutropenia and thrombocytopenia in the course of the disease. No grade 4 and above adverse reactions were observed. Conclusion R-MAD regimen is both safe and effective in the treatment of primary central nervous system neoplasms. Key words: Central nervous system neoplasms; Lymphoma; Immunotherapy; Drug therapy; Methotrexate; Cytarabine; Primary; Rituximab