{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:19:13Z","timestamp":1788279553158,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The treatment efficacy, acute toxicity, and neurocognitive sequelae of older patients with primary central nervous system lymphoma (PCNSL) remain therapeutic challenges. The standard first\u2010line therapy consisted of high\u2010dose methotrexate and cytarabine (AraC) and led to a complete response (CR) in half of the patients. To improve the response rate, we proposed intensifying the standard rituximab, methotrexate, procarbazine, vincristine, and cytarabine (R\u2010MPVA) regimen by sequentially adding etoposide (100\u00a0mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    D2) to R\u2010MPV (R\u2010MPV\u2010E) and ifosfamide (1.5\u00a0g\/m\n                    <jats:sup>2<\/jats:sup>\n                    Days 1\u20133) to R\u2010AraC (R\u2010AraC\u2010I) for patients aged between 60 and 70\u00a0years. The primary objective of this retrospective study was to determine the CR rates after three and two planned cycles of R\u2010MPV\u2010E and R\u2010AraC\u2010I, respectively. Thirty\u2010two consecutive patients received this regimen between 2013 and 2021 in Lyon University Hospitals. After the R\u2010MPV\u2010E and R\u2010AraC\u2010I sequences, 11 (34.4%) and 26 (81.3%) patients achieved CR or unconfirmed CR (CRu), respectively, with favorable safety profiles (19% and 38%, of \u2265\u00a0Grade 3 hematological toxicity; 19% and 27%, of \u2265\u00a0Grade 3 infection during the induction and consolidation, respectively). With a median follow\u2010up of 42.4\u00a0months, the 3\u2010year event\u2010free survival (EFS) and overall survival (OS) rates were 40.2% and 63.2%, respectively. Historical comparisons with a subset of patients from the LOC network database revealed an improvement in CR rates of 81% after R\u2010MPV\u2010E\/R\u2010AraC\u2010I versus 42.9% and 60.5% after MPVA and R\u2010MPVA, respectively, mainly owing to the addition of ifosfamide to the R\u2010AraC sequence. Similar results were observed in an independent retrospective cohort of 20 patients treated at Toulouse University\u2010Hospital, with a 70% CR rate after R\u2010MPV\u2010E\/R\u2010AraC\u2010I. In addition, 7\/26 (27%) CR\/CRu patients in the main cohort could then be referred for autograft consolidation. In conclusion, this study revealed that ifosfamide combined with R\u2010AraC could increase the CR\/CRu rate at the end of induction in 60\u201370\u2010year\u2010old PCNSL patients.\n                  <\/jats:p>","DOI":"10.1002\/hon.70217","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T19:06:34Z","timestamp":1783710394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intensified Rituximab, Methotrexate, Procarbazine, and Cytarabine (R\u2010MPVA) Regimen With Sequential Addition of Etoposide to R\u2010MPV and Ifosfamide to R\u2010AraC for Newly Diagnosed Primary CNS Lymphoma Patients Aged Between 60 and 70\u00a0Years: An LOC Network Study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6043-2580","authenticated-orcid":false,"given":"Gabriel","family":"Antherieu","sequence":"first","affiliation":[{"name":"Department of Hematology Hopital Lyon Sud Hospices Civils de Lyon Claude Bernard Lyon 1 University  Pierre Benite France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Julia","sequence":"additional","affiliation":[{"name":"Department of Hematology Hopital Lyon Sud Hospices Civils de Lyon Claude Bernard Lyon 1 University  Pierre Benite France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9opoldine","family":"Lapierre","sequence":"additional","affiliation":[{"name":"Department of Hematology IUC CHU Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5797-5744","authenticated-orcid":false,"given":"Marie","family":"Donzel","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospices Civils de Lyon Claude Bernard Lyon 1 University  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Houillier","sequence":"additional","affiliation":[{"name":"Neuro\u2010oncology Department H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re IHU, ICM, Inserm, CNRS Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Soussain","sequence":"additional","affiliation":[{"name":"Department of Hematology Institut Curie  Saint\u2010cloud France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Nicolas\u2010Virelizier","sequence":"additional","affiliation":[{"name":"Department of Hematology Centre Leon Berard Claude Bernard Lyon 1 University  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2833-1011","authenticated-orcid":false,"given":"Philippe","family":"Rey","sequence":"additional","affiliation":[{"name":"Department of Hematology Centre Leon Berard Claude Bernard Lyon 1 University  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Ducray","sequence":"additional","affiliation":[{"name":"Department of Neurology H\u00f4pital Neurologique Pierre Wertheimer Hospices Civils de Lyon Claude Bernard Lyon 1 University  Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Meyronet","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospices Civils de Lyon Claude Bernard Lyon 1 University  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6494-6725","authenticated-orcid":false,"given":"Thi\u00e9baud","family":"Picart","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery H\u00f4pital Neurologique Pierre Wertheimer Hospices Civils de Lyon Claude Bernard Lyon 1 University  Bron 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