Clinical outcomes of primary intraocular lymphoma patients treated with front-line systemic high-dose methotrexate and intravitreal methotrexate injection

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• 作者：Wei-Li Ma ; Hsin-An Hou ; Ya-Jui Hsu ; Yin-Kai Chen ; Jih-Luh Tang…
• 关键词：Methotrexate ; Primary intraocular lymphoma
• 刊名：Annals of Hematology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：95
• 期：4
• 页码：593-601
• 全文大小：3,002 KB
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• 作者单位：Wei-Li Ma (1) (2)
  Hsin-An Hou (1)
  Ya-Jui Hsu (3)
  Yin-Kai Chen (1)
  Jih-Luh Tang (1)
  Woei Tsay (1)
  Po-Ting Yeh (3)
  Chung-May Yang (3)
  Chang-Ping Lin (3)
  Hwei-Fang Tien (1) (4)
  
  1. Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  2. Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan
  3. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
  4. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Hematology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0584

文摘

A standard treatment for patients with primary intraocular lymphoma (PIOL) remains unclear. This study retrospectively analyzed the clinical features and outcomes of 19 patients with PIOL who were treated with a first-line therapy comprising combined intravenous high-dose methotrexate and intravitreal methotrexate between January 2003 and December 2013. Thirteen (68.4 %) patients were female, and the median age at diagnosis was 57 (39–77 years). Diagnoses were based on the identification of abnormal lymphoid cells in vitreous fluid. Ten (52.6 %) patients had bilateral eye involvement, and six had concurrent central nervous system (CNS) involvement. All 19 patients achieved complete remission (CR) as confirmed by cytological examination of vitreous and cerebrospinal fluid and brain imaging if CNS was involved. Patients with concurrent brain involvement required a longer time to achieve CR. However, the duration of complete remission did not differ between patients with and without CNS involvement. The 5-year overall survival rate was 55.8 % for the total cohort and was higher (68.8 %) in patients with isolated PIOL than in those with concurrent CNS involvement. In all patients, methotrexate treatment was well tolerated, with manageable side effects. We conclude that combined intravitreal methotrexate and systemic high-dose methotrexate treatment is effective in patients with PIOL.