Ibrutinib Monotherapy as Bridge-to-Transplant for Relapsed/Refractory Primary Oculo-Cerebral Lymphoma.

Dalma Deak-Mihaly, Sabina Iluta, Sergiu Pasca, Ciprian Jitaru, Andrei Roman, Alexandra Andries, Monica Padurariu-Covit, Bobe Petrushev, Anca Vasilache, Anca Bojan, Mihnea Zdrenghea, Angela Dascalescu, Ion Antohe, Anca Colita, Andrei Colita, Delia Dima, Alina Tanase, Ciprian Tomuleasa
Author Information
  1. Dalma Deak-Mihaly: Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400005 Cluj Napoca, Romania. ORCID
  2. Sabina Iluta: Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400005 Cluj Napoca, Romania.
  3. Sergiu Pasca: Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400005 Cluj Napoca, Romania.
  4. Ciprian Jitaru: Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400125 Cluj Napoca, Romania.
  5. Andrei Roman: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania. ORCID
  6. Alexandra Andries: Department of Radiology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj Napoca, Romania.
  7. Monica Padurariu-Covit: Department of Internal Medicine, Sf. Apostol Andrei Emergency County Hospital, 800366 Galati, Romania. ORCID
  8. Bobe Petrushev: Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
  9. Anca Vasilache: Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400125 Cluj Napoca, Romania.
  10. Anca Bojan: Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400005 Cluj Napoca, Romania.
  11. Mihnea Zdrenghea: Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400005 Cluj Napoca, Romania.
  12. Angela Dascalescu: Department of Hematology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
  13. Ion Antohe: Department of Hematology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
  14. Anca Colita: Department of Stem Cell Transplantation, Fundeni Clinical Institute, 420003 Bucharest, Romania.
  15. Andrei Colita: Department of Hematology, Coltea Hospital, 420003 Bucharest, Romania.
  16. Delia Dima: Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400125 Cluj Napoca, Romania.
  17. Alina Tanase: Department of Stem Cell Transplantation, Fundeni Clinical Institute, 420003 Bucharest, Romania. ORCID
  18. Ciprian Tomuleasa: Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400005 Cluj Napoca, Romania. ORCID

Abstract

INTRODUCTION: Primary central nervous system lymphoma is an uncommon form of extranodal non-Hodgkin's lymphoma, with increasing incidence, a relatively aggressive course and a poor 5-year survival. Because of its localization, the therapeutic compounds used in this disease must be able to pass through the blood-brain barrier. Chemotherapy regimens based on high-dose methotrexate are currently the standard of care for all patients who can tolerate such drugs. Autologous stem cell transplantation is indicated for malignant lymphomas in the relapsed/refractory setting.
METHODS: Three patients, with a median age of 60 years, range 53-64, were diagnosed with primary CNS lymphoma, and treated with ibrutinib monotherapy in the Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania, between September 2018 and November 2020 All the patients were relapsed-refractory following high-dose methotrexate chemotherapy. We present our experience using ibrutinib monotherapy-based treatment as a bridge-to-transplant option on a single-center case series and a review of the literature in this field.
RESULTS: Two of the patients were given ibrutinib as a second line therapy, both achieving complete remission and being eligible for an autologous stem cell transplantation. The third patient achieved a short remission using six cycles of systemic chemotherapy, but was started on ibrutinib monotherapy, with limited results.
CONCLUSION: Our data is limited, and these results should be confirmed by multicentric clinical trials and should be regarded as a single-center case series, with all its limitations. Still, it brings forward a new therapeutic option for this rare subtype of malignant lymphomas, which if left untreated has a dismal prognosis.

Keywords

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Word Cloud

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