Discussion
PCNSL
Treatment strategies for elderly PCNSL patients > 65 years are not well defined reflecting in inferior outcome in comparison to younger patients. Treatment of this vulnerable patient population is challenging because of a frequently poor PS and comorbidities [Judgment of who can profit from an intensive therapy approach remains difficult because standardized tools to define transplant eligibility are missing. We found GA scores like CIRS-G, ECOG PS, Barthel Index of ADL and Lachs geriatric screening to be associated with premature end of treatment as well as decreased PFS and OS in the MARTA and MARiTA study population, whereas age did not seem to play a major role[We aim to demonstrate the superiority of the MARTA induction protocol followed by consolidation with HCT-ASCT compared to the established standard therapy with conventional chemotherapy with R-MP and procarbazine maintenance, in terms of PFS. The implemented GA will create evidence on how to define transplant eligibility. This is the first randomized controlled trial investigating HCT-ASCT in this population of elderly patients. Results of this multicenter randomized trial will either change the standard of care to an intensive and shorter treatment approach or redefine R-MP as a proven treatment standard.