IV Rituximab 500 mg/m2 day 1 IV Methotrexate 3.5 mg/m2 (over 2hours) day 2 IV Vincristine 1.4 mg/m2 (capped at 2.8mg)day 2 Procarbazine 100 mg/m2 /day was given on days 2-8 during odd cycles.
1 cycle = 14 days
Standard hydration and leucovorin rescue were given per institutional guidelines. To prevent febrile neutropenia and toxic deaths previously observed with R-MPV, prophylactic filgrastim was given to all patients.
An MRI of the brain was performed after 5 cycles. Patients with progressive disease (PD) were taken off-study. Patients with complete response (CR) proceeded directly to HDC-ASCT. Patients in partial response (PR) or stable disease (SD) received two additional cycles, and proceeded with HDC-ASCT if PR/CR was observed on a repeat MRI, or taken off-study if SD or PD. After transplant, patients were followed radiographically, with no WBRT or further treatments offered until progression. Responses were assessed utilizing previously described criteria;18 in addition to CR, PR, SD and PD, those criteria also characterize unconfirmed CR (CRu), defined by absence of contrast-enhancing disease in the setting of corticosteroids use, or minimal enhancing abnormalities of uncertain significance, typically corresponding to postoperativechanges following biopsy.
R-MPV followed by high-dose chemotherapy with TBC and autologous stem-cell transplant for newly diagnosed primary CNS lymphoma Blood. 2015 Feb 26;125(9):1403-10. doi: 10.1182/blood-2014-10-604561. Epub 2015 Jan 7. Full Text