September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Combined intravitreal methotrexate and immunochemotherapy followed by reduced-dose whole-brain radiotherapy for newly diagnosed primary B-cell intraocular lymphoma
Author Affiliations & Notes
  • Junko Matsuda
    Ophthalmology, The Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Toshikatsu Kaburaki
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Rie Tanaka
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Mitsuko Takamoto
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Hisae Nakahara
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Kazuyoshi Ohtomo
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Yujiro Fujino
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Jiro Numaga
    Ophthalmology, The Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
  • Hideomi Yamashita
    Radiology, The University of Tokyo Hospital, Tokyo, Japan
  • Mineo Kurokawa
    Hematology, The University of Tokyo Hospital, Tokyo, Japan
  • Makoto Aihara
    Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
  • Footnotes
    Commercial Relationships   Junko Matsuda, None; Toshikatsu Kaburaki, None; Rie Tanaka, None; Mitsuko Takamoto, None; Hisae Nakahara, None; Kazuyoshi Ohtomo, None; Yujiro Fujino, None; Jiro Numaga, None; Hideomi Yamashita, None; Mineo Kurokawa, None; Makoto Aihara, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4093. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Junko Matsuda, Toshikatsu Kaburaki, Rie Tanaka, Mitsuko Takamoto, Hisae Nakahara, Kazuyoshi Ohtomo, Yujiro Fujino, Jiro Numaga, Hideomi Yamashita, Mineo Kurokawa, Makoto Aihara; Combined intravitreal methotrexate and immunochemotherapy followed by reduced-dose whole-brain radiotherapy for newly diagnosed primary B-cell intraocular lymphoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4093.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Primary intraocular lymphoma (IOL) has propensity for cerebrospinal relapse within two years of initial diagnosis, which aggravates clinical outcome. The purpose of our study was to determine whether early initiation of cerebrospinal prophylaxis with rituximab, methotrexate (MTX), procarbazine, and vincristine (R-MPV), reduced-dose whole-brain radiotherapy (rdWBRT), and high-dose cytarabine (HD-AraC) reduced the cerebrospinal relapse rate and improved 2-year progression-free survival (PFS) and overall survival (OS) in patients with primary IOL.

Methods : Patients and methods:
Primary B-cell IOL patients with or without newly diagnosed cerebrospinal involvement were treated 10 times with intravitreal MTX and five to seven cycles of R-MPV. Patients that achieved a complete response received rdWBRT (23.4 Gy). Two cycles of HD-AraC were given after rdWBRT. All patients received longitudinal magnetic resonance imaging (MRI) of the brain and cognitive assessment for evaluation of treatment-induced leukoencephalopathy.

Results : Fifteen patients with a median age of 63 years and a median Karnofsky performance score of 90 received the complete protocol treatment. Cerebrospinal relapse occurred in one patient and intraocular relapse occurred in two patients. The 2-year PFS was 78.8% and the 4-year OS was 92.3% with a median follow-up of 52.2 months. Of the 10 patients without cerebrospinal involvement at initial diagnosis, no cerebrospinal relapse occurred, and the 4-year OS was 100% with a median follow-up of 55.3 months. All patients had preserved cognitive function during follow-up. Although white matter abnormalities on MRI increased gradually, no patients developed modified Fazekas of grades 4 to 5.

Conclusions : The 20% relapse rate achieved in our study is the lowest in any reports regarding primary IOL to date (53.8–78.9%). The early cerebrospinal prophylaxis with chemotherapy and radiotherapy in primary B-cell IOL patients reduced the cerebrospinal relapse rate and improved 2-year PFS and OS without compromising neurocognitive function.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×