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Primary Intraocular Lymphoma Patients Respond to Methotrexate Therapy: Presented at ARVO

By Ed Susman

FT. LAUDERDALE, F.L. -- May 5, 2006 -- Treatment with high-dose intravenous methotrexate considerably extends survival in patients with a rare cancer -- primary intraocular lymphoma -- doctors reported here at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting.

"Untreated patients diagnosed with this disease die within 6 months," said Dino Klisovic, MD, fellow in ophthalmology, Massachusetts Eye Research and Surgery Institute, Boston, Massachusetts. "Radiation therapy in the eye and the brain leads to a prognosis of 12 to 18 months, but less than 5% of patients survive 5 years."

He said that treatment with IV methotrexate increases survival to greater than 55 months and results in remissions. The success with this treatment has allowed doctors to reserve radiation as a salvage regimen, Dr. Klisovic said in a poster presentation May 1^st.

In his retrospective look at treatments for primary intraocular lymphoma with high-dose IV methotrexate in which the exact dosing of methotrexate varied among patients, Dr. Klisovic enrolled 12 patients who fit the trial inclusion criteria. The average age of the patients was 59 years, and the majority were women, he said, reflecting the gender differences seen historically.

Of those patients, the average survival from time of diagnosis was 55.3 months compared with 12 to 41 months among historical comparators. About 69% of patients treated with methotrexate lost more than 4 lines of vision compared with 76% of historical controls. Two of 12 patients (17%) died by the end of the study compared with 85% of historical controls. Five clinical remissions were observed among the methotrexate patients compared with 15% of controls.

About 300 cases of the primary intraocular lymphoma emerge each year in the United States, commented John Gonzales, PhD, researcher, National Eye Institute, National Institutes of Health, Bethesda, Maryland, who was not involved in Dr. Klisovic's study. "However, that is an increase that has risen 10-fold in the United Stated in the past 2 decades." The reason for this increase in incidence is not yet understood, he added.


[Presentation title: Primary Intraocular Lymphoma: A Retrospective Analysis of Treatment and Mortality. Abstract 2830]

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