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Remission rates for primary central nervous system lymphoma have been boosted by adding cytarabine to high-does methotrexate monochemotherapy, according to research published in the Lancet.
A team at the San Raffaele H Scientific Institute in Milan reports that the combination resulted in remission rates of 46% compared with 18% for methotrexate alone. Partial response rates were 69% and 40%.
Says author Dr Andres Ferreri: “The addition of high-dose cytarabine to high-dose methotrexate is associated with a remarkable outcome benefit in patients with primary CNS lymphoma.
“This combination could be used as an upfront approach in patients aged 75 years and younger and with adequate liver and kidney function, with appropriate antimicrobial prophylaxis.”
Seventy-nine patients aged 18-75 with non-Hodgkin lymphoma received four courses of either methotrexate 3·5 g/m2 on day 1 (40 patients) or methotrexate 3·5 g/m2 on day 1 plus cytarabine 2 g/m2 twice a day on days 2 and 3 (39).
Copyright Press Association 2009