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This treatment protocol is a consolidation therapy for primary central nervous system lymphoma (PCNSL) in patients aged 60 years and younger, evaluated in the PRECIS (ANOCEF-GOELAMS) randomized phase II trial. The protocol consists of intensive chemotherapy using the TBC regimen—a combination of high-dose thiotepa, busulfan, and cyclophosphamide—followed by autologous hematopoietic stem cell rescue (ASCT). This approach is typically administered after induction with methotrexate-based chemotherapy (such as R-MBVP) to achieve deep remission and eliminate residual lymphoma cells in the central nervous system while avoiding the long-term neurotoxicity associated with whole-brain radiotherapy (WBRT). The high-dose alkylating agents are selected for their ability to penetrate the blood-brain barrier, and the subsequent stem cell rescue is required to mitigate the severe myelosuppression caused by the intensive chemotherapy.
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