Efficacy and Safety Profile of a Rituximab, Methotrexate, and Thiotepa‐Based Regimen in Newly Diagnosed Primary CNS Lymphoma

To evaluate the efficacy and safety of the RMT regimen as first‐line induction therapy for primary central nervous system diffuse large B‐cell lymphoma (PCNS‐DLBCL), we retrospectively analyzed 36 patients treated with 4–6 cycles of RMT. After 4 induction cycles, the overall response rate and complete response rate were 97.2% and 80.6%, respectively. With a median follow‐up of 19.9 months, the 2‐year progression‐free survival (PFS) and overall survival rates were 64.4% and 79.3%. The 2‐year PFS was 100% in patients receiving sequential autologous stem cell transplantation (ASCT), 67.9% with maintenance therapy (BTKi/IMiD), and 45.5% with induction only. The most common Grades 3–4 adverse event was neutropenia (33.3%); all were manageable without treatment discontinuation. These findings indicate that the RMT regimen demonstrates excellent efficacy and a favorable safety profile in PCNS‐DLBCL, including elderly patients; sequential ASCT is the preferred consolidation strategy, while BTKi/IMiD maintenance provides a viable alternative for sustained disease control.