Folia Neuropathologica

Successful treatment of central nervous system relapse of primary mediastinal large B-cell lymphoma with the R-MIV regimen: a case report

  1. Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland

  2. Department of Pathomorphology, University Clinical Centre, Medical University of Warsaw, Warsaw, Poland

  3. Second Department of Radiology, Medical University of Warsaw, Warsaw, Poland

  4. Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland

  5. Department of Nuclear Medicine, The National Institute of Medicine of the Ministry of the Interior and Administration, Warsaw, Poland

Folia Neuropathol 2026; 64

Data publikacji online: 2026/10/07
Article file
FN Successful.pdf
  1. Abrey LE, Moskowitz CH, Mason WP, Crump M, Stewart D, Forsyth P, Paleologos N, Correa DD, Anderson ND, Caron D, Zelenetz A, Nimer SD, DeAngelis LM. Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. J Clin Oncol 2003; 21: 4151-4156.
  2. Alaggio R, Amador C, Anagnostopoulos I, Attygalle AD, Araujo IBO, Berti E, Bhagat G, Borges AM, Boyer D, Calaminici M, Chadburn A, Chan JKC, Cheuk W, Chng WJ, Choi JK, Chuang SS, Coupland SE, Czader M, Dave SS, de Jong D, Du MQ, Elenitoba-Johnson KS, Ferry J, Geyer J, Gratzinger D, Guitart J, Gujral S, Harris M, Harrison CJ, Hartmann S, Hochhaus A, Jansen PM, Karube K, Kempf W, Khoury J, Kimura H, Klapper W, Kovach AE, Kumar S, Lazar AJ, Lazzi S, Leoncini L, Leung N, Leventaki V, Li XQ, Lim MS, Liu WP, Louissaint Jr A, Marcogliese A, Medeiros LJ, Michal M, Miranda RN, Mitteldorf C, Montes-Moreno S, Morice W, Nardi V, Naresh KN, Natkunam Y, Ng SB, Oschlies I, Ott G, Parrens M, Pulitzer M, Rajkumar SV, Rawstron AC, Rech K, Rosenwald A, Said J, Sarkozy C, Sayed S, Saygin C, Schuh A, Sewell W, Siebert R, Sohani AR, Tooze R, Traverse-Glehen A, Vega F, Vergier B, Wechalekar AD, Wood B, Xerri L, Xiao W. The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia 2022; 36: 1720-1748.
  3. Alderuccio JP, Nayak L, Cwynarski K. How I treat secondary CNS involvement by aggressive lymphomas. Blood 2023; 142: 1771-1783.
  4. Boehme V, Schmitz N, Zeynalova S, Loeffler M, Pfreundschuh M. CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Blood 2009; 113: 3896-3902.
  5. Camus V, Rossi C, Sesques P, Lequesne J, Tonnelet D, Haioun C, Durot E, Willaume A, Gauthier M, Moles-Moreau MP, Antier C, Lazarovici J, Monjanel H, Bernard S, Tardy M, Besson C, Lebras L, Choquet S, Le Du K, Bonnet C, Bailly S, Damaj G, Laribi K, Maisonneuve H, Houot R, Chauchet A, Jardin F, Traverse-Glehen A, Decazes P, Becker S, Berriolo-Riedinger A, Tilly H. Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma: a LYSA study. Blood Adv 2021; 5: 3862-3872.
  6. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA; Australasian Leukaemia Alliance, Group Lymphoma, Group Eastern Cooperative Oncology, Consortium European Mantle Cell Lymphoma, Foundation Italian Lymphoma, Research European Organisation for, Group Treatment of Cancer/Dutch Hemato-Oncology, Osea Grupo Espanol de Medula, Group German High-Grade Lymphoma Study, Group German Hodgkin’s Study, Group Japanese Lymphorra Study, Association Lymphoma Study, Ncic Clinical Trials Group, Group Nordic Lymphoma Study, Group Southwest Oncology, Institute United Kingdom National Cancer Research. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014; 32: 3059-3068.
  7. Coupland SE, Du MQ, Ferry JA, de Jong D, Khoury JD, Leoncini L, Naresh KN, Ott G, Siebert R, Xerri L; WHO 5th Edition Classification Project. The fifth edition of the WHO classification of mature B-cell neoplasms: open questions for research. J Pathol 2024; 262: 255-270.
  8. Dulery R, Lamure S, Delord M, Di Blasi R, Chauchet A, Hueso T, Rossi C, Drenou B, Deau Fischer B, Soussain C, Feugier P, Noel N, Choquet S, Bologna S, Joly B, Philippe L, Kohn M, Malak S, Fouquet G, Daguindau E, Taoufik Y, Lacombe K, Cartron G, Thieblemont C, Besson C. Prolonged in-hospital stay and higher mortality after Covid-19 among patients with non-Hodgkin lymphoma treated with B-cell depleting immunotherapy. Am J Hematol 2021; 96: 934-944.
  9. Ferreri AJM, Cwynarski K, Pulczynski E, Fox CP, Schorb E, Celico C, Falautano M, Nonis A, La Rosee P, Binder M, Fabbri A, Ilariucci F, Krampera M, Roth A, Hemmaway C, Johnson PW, Linton KM, Pukrop T, Gorlov JS, Balzarotti M, Hess G, Keller U, Stilgenbauer S, Panse J, Tucci A, Orsucci L, Pisani F, Zanni M, Krause SW, Schmoll HJ, Hertenstein B, Rummel M, Smith J, Thurner L, Cabras G, Pennese E, Ponzoni M, Deckert M, Politi LS, Finke J, Ferranti A, Cozens K, Burger E, Ielmini N, Cavalli F, Zucca E, Illerhaus G. Ielsg study investigators. Long-term efficacy, safety and neurotolerability of MATRix regimen followed by autologous transplant in primary CNS lymphoma: 7-year results of the IELSG32 randomized trial. Leukemia 2022; 36: 1870-1878.
  10. Ferreri AJM, Illerhaus G, Doorduijn JK, Auer DP, Bromberg JEC, Calimeri T, Cwynarski K, Fox CP, Hoang-Xuan K, Malaise D, Ponzoni M, Schorb E, Soussain C, Specht L, Zucca E, Buske C, Jerkeman M, Dreyling M, Eha, Esmo Guidelines Committees. Primary central nervous system lymphomas: EHA-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2024.
  11. Korfel A, Elter T, Thiel E, Hanel M, Mohle R, Schroers R, Reiser M, Dreyling M, Eucker J, Scholz C, Metzner B, Roth A, Birkmann J, Schlegel U, Martus P, Illerhaus G, Fischer L. Phase II study of central nervous system (CNS)-directed chemotherapy including high-dose chemotherapy with autologous stem cell transplantation for CNS relapse of aggressive lymphomas. Haematologica 2013; 98: 364-370.
  12. Liu PP, Wang KF, Xia Y, Bi XW, Sun P, Wang Y, Li ZM, Jiang WQ. Racial patterns of patients with primary mediastinal large B-cell lymphoma: SEER analysis. Medicine (Baltimore) 2016; 95: e4054.
  13. Martelli M, Ceriani L, Ciccone G, Ricardi U, Kriachok I, Botto B, Balzarotti M, Tucci A, Usai SV, Zilioli VR, Pennese E, Arcaini L, Dabrowska-Iwanicka A, Ferreri AJM, Merli F, Zhao W, Rigacci L, Cellini C, Hodgson D, Ionescu C, Minoia C, Lucchini E, Spina M, Fossa A, Janikova A, Cwynarski K, Mikhaeel G, Jerkeman M, Di Rocco A, Stepanishyna Y, Vitolo U, Santoro A, Re A, Puccini B, Olivieri J, Petrucci L, Barrington SF, Malkowski B, Metser U, Versari A, Chauvie A, Walewski J, Trneny M, Cavalli F, Gospodarowicz M, Johnson PWM, Davies A, Zucca E; Group International Extranodal Lymphoma Study. Omission of radiotherapy in primary mediastinal B-cell lymphoma: IELSG37 trial results. J Clin Oncol 2024; 42: 4071-4083.
  14. Ostrowska B, Domanska-Czyz K, Romejko-Jarosinska J, Osowiecki M, Targonski L, Poplawska L, Konecki R, Kotarska M, Szymanski M, Borawska A, Swierkowska M, Dabrowska-Iwanicka A, Druzd-Sitek A, Paszkiewicz-Kozik E, Mroz-Zycinska E, Tajer J, Wojciechowska-Lampka E, Osiadacz W, Rymkiewicz G, Lapinska G, Wojewodzka-Mirocha M, Michalski W, Walewski J. Safety and efficacy of induction immunochemotherapy with rituximab, methotrexate, ifosfamide, and vincristine (R-MIV) in patients with primary CNS lymphoma including recent COVID-19 pandemic experience. Br J Haematol 2023; 201: 663-672.
  15. Papageorgiou SG, Diamantopoulos P, Levidou G, Angelopoulou MK, Economopoulou P, Efthimiou A, Constantinou N, Katsigiannis A, Korkolopoulou P, Pappa V, Economopoulou C, Georgiou G, Dimou M, Tsirigotis P, Kyrtsonis MC, Kotsianidis I, Kalpadakis C, Dimopoulos MA, Beris P, Meletis J, Pangalis GA, Dervenoulas J, Panayiotidis P, Vassilakopoulos TP. Isolated central nervous system relapses in primary mediastinal large B-cell lymphoma after CHOP-like chemotherapy with or without Rituximab. Hematol Oncol 2013; 31: 10-17.
  16. Renaud L, Donzel M, Decroocq J, Decazes P, Galtier J, Burroni B, Veresezan EL, Sesboue C, Dartigues P, Chassagne-Clement C, Martin L, Mauduit C, Kaltenbach S, Penther D, Etancelin P, Sibon D, Bailly S, Martin V, Durot E, Kirova Y, Grenier A, Maerevoet M, Bernard W, Naveau L, Cabannes-Hamy A, Cottereau AS, Jacquet-Francillon N, Noel R, Reichert T, Sarkozy C, Bussot L, Bailly S, Amorim S, Krzisch D, Cornillon J, Legendre H, Chevillon F, Cavalieri D, Sesques P, Minard-Colin V, Haioun C, Morschhauser F, Houot R, Jardin F, Tilly H, Traverse-Glehen A, Camus V. Primary mediastinal B-cell lymphoma (PMBCL): The LYSA pragmatic guidelines. Eur J Cancer 2025; 220: 115369.
  17. Scordo M, Wang TP, Ahn KW, Chen Y, Ahmed S, Awan FT, Beitinjaneh A, Chen A, Chow VA, Dholaria B, Epperla N, Farooq U, Ghosh N, Grover N, Hamad N, Hildebrandt GC, Holmberg L, Hong S, Inwards DJ, Jimenez-Jimenez A, Karmali R, Kenkre VP, Khimani F, Klyuchnikov E, Krem MM, Munshi PN, Nieto Y, Prestidge T, Ramakrishnan Geethakumari P, Rezvani AR, Riedell PA, Seo S, Shah NN, Solh M, Yared JA, Kharfan-Dabaja MA, Herrera A, Hamadani M, Sauter CS. Outcomes associated with thiotepa-based conditioning in patients with primary central nervous system lymphoma after autologous hematopoietic cell transplant. JAMA Oncol 2021; 7: 993-1003.
  18. Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, Klasa R, Savage KJ, Shenkier T, Sutherland J, Gascoyne RD, Connors JM. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 2007; 109: 1857-1861.
  19. Thieblemont C, Gomes Da Silva M, Leppa S, Lenz G, Cottereau AC, Fox C, Lopez-Guillermo A, Illidge T, Jurczak W, Eich H, Aurer I, Trneny M, Rosenwald AA, Davies A, Zwezerijnen BG, Bolanos N, Markovic M, Jais JP, Broussais F, Dreyling M, Vitolo U, Tilly H, Kersten MJ. Large B-cell lymphoma (LBCL): EHA Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Hemasphere 2025; 9: e70207.
  20. Villa D, Connors JM, Shenkier TN, Gascoyne RD, Sehn LH, Savage KJ. Incidence and risk factors for central nervous system relapse in patients with diffuse large B-cell lymphoma: the impact of the addition of rituximab to CHOP chemotherapy. Ann Oncol 2010; 21: 1046-1052.
  21. Zucca E, Ceriani L, Ciccone G, Di Rocco A, Pirosa MC, Kriachok I, Botto B, Balzarotti M, Tucci A, Usai SV, Zilioli VR, Pennese E, Arcaini L, Dabrowska-Iwanicka A, Ferreri AJM, Merli F, Zhao W, Rigacci L, Cellini C, Hodgson D, Ionescu C, Minoia C, Lucchini E, Spina M, Fossa A, Janikova A, Cwynarski K, Mikhaeel NG, Jerkeman M, Stathis A, Cozens K, Ielmini N, De Martino I, Walewski J, Trneny M, Cavalli F, Ricardi U, Johnson PWM, Davies A, Martelli M. Impact of immunochemotherapy regimens on outcomes of patients with primary mediastinal B-cell lymphoma in the IELSG37 trial. Blood 2025; 146: 2758-2764.
Copyright: © 2026 Mossakowski Medical Research Centre Polish Academy of Sciences and the Polish Association of Neuropathologists. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Share
without publication fees