A Single-center Retrospective Study of MIAD ± R Chemotherapy in Newly Diagnosed Primary Central Nervous System Lymphoma: Safety Profiles and Clinical Outcomes.

BACKGROUND: The optimal induction therapy for primary central nervous system lymphoma (PCNSL) has not been well-established. The aim of this study was to evaluate clinical efficacy and safety of the MIAD ± R (methotrexate, ifosfamide, cytarabine, dexamethasone, and with/without rituximab) regimen in patients with newly diagnosed PCNSL. PATIENTS AND METHODS: In this monocentric retrospective study, we collected clinical data from PCNSL patients treated with MIAD ± R to report our institutional experience with this regimen in real-world practice. Patient demographic and clinical data were analyzed using descriptive statistics. The Kaplan-Meier curves were employed to estimate overall survival (OS) and progression-free survival (PFS). RESULTS: Eighty-one patients were consecutively included with a median follow-up of 23.1 months (95% confidence interval [CI], 17.6-28.6), among which, 50 (61.7%) patients achieved complete remission (CR), 25 (30.9%) achieved partial remission (PR), 3 (3.7%) had stable disease (SD) and 3 (3.7%) had progression of disease (PD). The objective response rate (ORR) was 92.6%. The median PFS was 11.8 months (95% CI, 4.9-18.7), and the 1-year PFS rate was 49.2%. The median overall survival (OS) was not reached; the 1-year OS rate was 93.5%. Adverse events (AEs) were manageable with standard supportive care; neutropenia (66.7%) and alanine aminotransferase/aspartate aminotransferase elevations (63%) were the most common events. No treatment related death was recorded. CONCLUSIONS: The MIAD ± R regimen is a viable treatment option for newly diagnosed PCNSL with favorable efficacy and an acceptable safety profile. Further prospective trials are warranted to verify its value in the first-line standard of treatment in PCNSL.