ArticleCancer medicine2026
Comparative Outcomes of Consolidation Strategies After R-MVP Induction in Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System.
Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Toxicity-Tailored Thresholds of Delayed Methotrexate Elimination in Non-Hodgkin Lymphoma: A Population-Based Approach to Therapy Optimization.European journal of drug metabolism and pharmacokinetics · 2026Article
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10 authors.
Funding
Abstract
backgroundThe optimal consolidation strategy following high-dose methotrexate (MTX)-based induction in primary central nervous system lymphoma (PCNSL) remains controversial. This study compared real-world outcomes of different consolidation modalities in patients responsive to rituximab, MTX, vincristine, and procarbazine (R-MVP) induction chemotherapy.
methodsWe retrospectively analyzed 296 newly diagnosed PCNSL patients treated with R-MVP between 2008 and 2023. Among 290 evaluable patients, the overall response rate (ORR) was assessed, and survival outcomes were evaluated by Kaplan-Meier and Cox regression analyses. Propensity score matching (PSM) was performed to compare autologous stem-cell transplantation (ASCT) and whole-brain radiotherapy (WBRT).
resultsThe ORR was 89.7%, with 71.7% achieving complete response (CR) or complete response unconfirmed (CRu) and 17.9% partial response (PR). Of 260 responders, 190 received consolidation: WBRT (40.8%), ASCT (20.0%), or non-myelosuppressive chemotherapy (NMC; 12.3%). After a median follow-up of 45.3 months, median progression-free survival (PFS) and overall survival (OS) for responders were 65.8 (95% CI 50.7-80.8) and 84.6 months (95% CI 66.5-102.7), respectively. ASCT yielded the most favorable survival (median PFS not reached), followed by WBRT (70.8 months), whereas NMC and no-consolidation groups showed significantly inferior PFS (22.9 and 40.1 months, p < 0.001). OS showed a similar trend (p = 0.006). On multivariable analysis, elevated LDH and consolidation type were independent predictors of PFS, whereas age and consolidation type were significant prognostic factors for OS. In the PSM cohort (ASCT vs. WBRT, n = 52 each), median PFS was not reached for ASCT versus 90.0 months for WBRT (p = 0.050); OS was not reached versus 97.9 months (p = 0.160).
conclusionsASCT was associated with the most durable survival among consolidation strategies after R-MVP induction. These findings, derived from a large real-world, multi-institutional cohort, support ASCT as the preferred consolidation for eligible patients while underscoring the heterogeneity of current practice and the need for prospective validation.
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