Unique ID issued by UMIN | UMIN000007821 |
---|---|
Receipt number | R000002307 |
Scientific Title | A Prospective Study of Diagnosis and Therapeutics in Intraocular Malignant Lymphoma |
Date of disclosure of the study information | 2012/04/23 |
Last modified on | 2021/05/14 11:02:58 |
A Prospective Study of Diagnosis and Therapeutics in Intraocular Malignant Lymphoma
A Prospective Study of Diagnosis and Therapeutics in Intraocular Malignant Lymphoma
A Prospective Study of Diagnosis and Therapeutics in Intraocular Malignant Lymphoma
A Prospective Study of Diagnosis and Therapeutics in Intraocular Malignant Lymphoma
Japan |
Uveitis suspected as Intraocular Malignant Lymphoma
Hematology and clinical oncology | Ophthalmology | Radiology |
Malignancy
NO
1) We perform vitrectomy to obtain the vitreous samples of uveitis suspected as intraocular malignant lymphoma (IOL), and determine the diagnosis of IOL according to the diagnostic criteria we determined. By following-up the cases, we evaluate the accuracy of the diagnostic criteria.
Others
2) We perform the treatments (intraocular methotrexate injections, systemic chemotherapy and low-dose whole brain radiation therapy (23.4Gy)) according to the treatment protocol we determined. By following-up the cases, we evaluate the efficacy of the protocol prospectively.
Confirmatory
Pragmatic
Not applicable
Diagnostic efficacy (sensitivity) of the diagnostic criteria
Local recurrence ratio, systemic recurrence ratio, overall survival, progression-free survival
Classification of the papanicolaou staing of the vitrecous specimens, concentration of IL10/IL-6 of vitreous samples, IgH monoclonarity, final visual acuity, site of systemic dissemination, term during therapy and recurrence
Interventional
Parallel
Non-randomized
Open -no one is blinded
Active
4
Treatment
Medicine | Other |
1)Primary Intraocular lymphoma (IOL) only with primary systemic malignant lymphoma (ML): intravitreal injection of 0.4mg of MTX(totally 10times, once a week for 2 months and once a month for 2 months)+ R-MPV therapy (1st day:rituximab 375mg/m2, 2nd day: oncovin 1.4mg/m2 (maximum 2mg)+MTX 3.5g/m2, 1-7day: procarbazine 100mg/m2 (odd number course only)) 5-7 course + whole-brain radiotherapy (totally 23.4 Gy) + High dose Ara C therapy 2 course (High dose cytarabine 3 g/m2/day (maximum daily dose 6g) for 2 days).
Systemic chemotherapy will be performed repeatedly 5 courses, one course in every 2 or 3 weeks.
2)Primary Intraocular lymphoma (IOL) with primary systemic malignant lymphoma (ML): intravitreal injection of 0.4mg of MTX(totally 10times, once a week for 2 months and once a month for 2 months)+ R-MPV therapy (1st day:rituximab 375mg/m2, 2nd day: oncovin 1.4mg/m2 (maximum 2mg)+MTX 3.5g/m2, 1-7day: procarbazine 100mg/m2 (odd number course only)) 5-7 course + whole-brain radiotherapy (totally 23.4-45 Gy) + High dose Ara C therapy 2 course (High dose cytarabine 3 g/m2/day (maximum daily dose 6g) for 2 days).
Systemic chemotherapy will be performed repeatedly 5 courses, one course in every 2 or 3 weeks.
In cases of recurrence of intraocular lymphoma without systemic lymphoma:
intravitreal injection of 0.4mg of MTX (totally 10 times, once a week for 2 months and once a month for 2 months) only.
In cases of intraocular lymphoma with systemic lymphoma or with the previous history of systemic lymphoma:
Local injection of MTX (totally 10 times, once a week for 2 months and once a month for 2 months, systemic chemotherapy, irradiation (Stem cell transplantation should be considered. Contents of chemotherapy are not specified.)
20 | years-old | <= |
80 | years-old | >= |
Male and Female
Age: 20-75 years old
Selection criteria
1) cases with uveal inflammation, which is suspected as intraocular malignant lymphoma, and vitreous biopsy was done for diagnostic purposes.
2) Diagnostic criteria for intraocular lymphoma is as follows.
(a) the vitreous fluid cytology
(class 5) 3 points
(Class 4) 2 points
(Class 3) 1 point
(b) IL-10/IL-6 (>1) or IL-10> 50pg/ml) 2 points
(c) IgH monoclonality 2 points
(d) FACS (distribution of kappa and lambda) 2 points
(e) funduscopic findings that are characteristic of intraocular lymphoma (the aurora-like vitreous opacity or patchy cell infiltration of the retina (often with serous retinal detachment)). 1 point
(f) the pathological diagnosis of malignant lymphoma of the eye or other organs before. 1 point
If the sum of these 6 items is more than 4 points, we diagnose intraocular lymphoma.
3) adaptation of the treatment protocol: Ccr> 50
Except for performance status 4
150
1st name | RIE |
Middle name | |
Last name | TANAKA |
University of Tokyo Hospital
Ophthalmology
113-8655
7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
03-3815-5411
rtanaka-ymn@umin.ac.jp
1st name | RIE |
Middle name | |
Last name | TANAKA |
University of Tokyo Hospital
Ophthalmology
113-8655
7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
03-3815-5411
rtanaka-ymn@umin.ac.jp
Deportment of Ophthalmology, University of Tokyo Hospital
Deportment of Ophthalmology, University of Tokyo Hospital
Self funding
Japan
Cancer institute hospital of Japanese Foundation For Cancer Research
The Research Ethics Committee of the Graduate School of Medicine and Faculty of Medicine at The University of Tokyo
7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
03-5841-0818
ethics@m.u-tokyo.ac.jp
NO
東京大学付属病院眼科(東京都)
2012 | Year | 04 | Month | 23 | Day |
Published
https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.14848
17
17 patients initiated and 16 completed the treatment. CNS relapse occurred in 2 and intraocular relapse in 3. 4-year PFS was 74.9% and 4-year OS was 86.3%. Of 11 patients without CNS involvement, 1 had CNS relapse and 3 intraocular relapse, and 4-year PFS was 72.7% and 4-year OS was 88.9%. No patients developed dementia/leukoencephalopathy. The combination of intravitreal chemotherapy, systemic chemotherapy and rdWBRT for B-cell PIOL showed a potential to reduce CNS relapse and improved 4-year PFS and OS.
2020 | Year | 05 | Month | 09 | Day |
Completed
2009 | Year | 01 | Month | 01 | Day |
2008 | Year | 11 | Month | 21 | Day |
2009 | Year | 01 | Month | 01 | Day |
2023 | Year | 11 | Month | 21 | Day |
Kaburaki T, Taoka K, Matsuda J, Yamashita H, Matsuda I, Tsuji H, Tanaka R, Nakazaki K, Nakamura F, Kamiya K, Kurokawa M, Ohtomo K, Aihara M. Combined intravitreal methotrexate and immunochemotherapy followed by reduced-dose whole-brain radiotherapy for newly diagnosed B-cell primary intraocular lymphoma. Br J Haematol. 2017 Oct;179(2):246-255. doi: 10.1111/bjh.14848.
2012 | Year | 04 | Month | 23 | Day |
2021 | Year | 05 | Month | 14 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000002307