Abstract
Purpose :
Because of the rarity of the disease, the management of isolated vitreoretinal lymphoma (VRL) remains controversial. VRL prognosis remains severe, mainly because of the risk of central nervous system lymphoma development. The objective of this study is to evaluate the efficiency and safety of high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HCT-ASCT) for the treatment of recurrent relapsing VRL.
Methods :
We retrospectively reviewed medical records of patients seen by the French LOC network between 2007 and 2016 with isolated vitreoretinal relapse of either primary vitreoretinal lymphoma, oculocerebral lymphoma, or systemic lymphoma and treated with HCT-ASCT.
Results :
18 patients (8 F/10 M), all immunocompetent, were included in the study. Mean age at HCT-ASCT was 59.17 (range 41 years-73 years). Median Karnofsky Performance status before HCT-ASCT was 90. At diagnosis, 8/18 had PVRL, 9/18 Primary Central Nervous Cells Lymphoma (PCNCL), 1/18 systemic lymphoma. Before HCT-ASCT, patients had received a median number of 1 line of treatment including high-dose methotrexate for all patients. All the patients received a thiotepa-based HCT. After HCT-ASCT, 14 patients experienced a complete response. No« toxic death » occurred. After a mean follow-up of 34.5 months (range: 8-82), 7/18 patients had recurrences (3 VRL relapses, 1 cerebral relapse, 3 ocular and cerebral relapses). The 1 year survival rate was 94.4%.
Conclusions :
Intensive chemotherapy followed by autologous stem cell transplant is an aggressive therapeutic approach but appear to give interesting results in young and fit patients with recurrent refractory vitreoretinal lymphoma.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.