Combined Systemic and Intrathecal Chemotherapy Followed by High-dose Chemotherapy and Autologous Stem Cell Transplantation for CNS Relapse of Aggressive Lymphomas
Inclusion Criteria:
- highly-malignant non-Hodgkins-Lymphoma, mantle-cell lymphoma or follicular lymphoma
3°
- CNS relapse (meningeal or/and intraparenchymal) with or without systemic lymphoma
manifestations
- ECOG performance score ≤2
- no active infection
- negative HIV-serology
- adequate renal function (creatinine clearance > 50 ml/min)
- adequate bone marrow function (granulocytes >1500/μl, platelets > 80000/μl)
- normal bilirubin, AST < 3 x UNL
- negative pregnancy test
Exclusion Criteria:
- newly diagnosed NHL with primary CNS involvement
- indolent NHL, lymphoblastic NHL or Burkitt lymphoma
- preceding CNS irradiation
- pretreatment of CNS relapse other than corticosteroids
- immunosuppression, concomitant immunosuppressive therapy, status after organ
transplantation or allogenous stem cell transplantation
- second cancer other than basalioma or cervical carcinoma in situ within the last 5
years
- unfit to receive an intensive chemotherapy
- pregnancy or breastfeeding
- known intolerance to MTX, ifosfamide, Depocyte, cytarabine, thiotepa, carmustine or
etoposide