The aim of this study was to evaluate the efficacy and toxicity of two 
chemotherapy regimens based on platinum and cytarabine in association with 
etoposide and methylprednisolone (ESHAP) or with dexamethasone (DHAP) with or 
without Rituximab (± R) in patients with refractory or a relapsed Primary 
Central Nervous System Lymphoma (PCNSL). All consecutive patients from two 
French centers with refractory or relapsed PCNSL treated with ESHAP/DHAP ± R 
were included. We analyzed the overall response rate (ORR), toxicity and overall 
survival (OS) after salvage chemotherapy. Intensive chemotherapy and 
hematopoietic stem cell rescue (IC + HCR) was offered to patients less than 65 
years of age and consisted of high-dose thiotepa, busulfan and cyclophosphamide. 
These results were compared with two previously reported series of PCNSL 
patients treated with the CYVE (high-dose cytarabine and etoposide) regimen at 
relapse. Twenty-two patients received a total of 60 DHAP/ESHAP cycles (median 3; 
range 1-5). The median age was 59 years. The ORR after salvage chemotherapy was 
59%. Toxicity was mainly hematological, 18% of patients showing febrile 
neutropenia. There was no treatment-related death. ESHAP or DHAP regimens led to 
similar ORRs compared to the CYVE regimen in relapsed or refractory PCNSL, 
although they seemed less toxic. The therapeutic results of the ESHAP/DHAP 
regimens in relapsed or refractory PCNSL were also similar to those for relapsed 
systemic non-Hodgkin's lymphomas (sNHL). Both chemotherapies, CYVE regimen and 
ESHAP/DHAP are treatment options to be considered in relapsed or refractory 
PCNSL, especially when IC + HCR is planned as a consolidation treatment. More 
efforts are still needed to improve the ORR at relapse.