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Real-World Data (RWD) on the 3-Year Follow-Up Outcomes of Different CNS Prophylaxis Strategies Across CNS-IPI Risk Groups in Patients With Diffuse Large B-Cell Non-Hodgkin Lymphoma
- Source :
- JCO Global Oncology
- Publication Year :
- 2021
- Publisher :
- American Society of Clinical Oncology (ASCO), 2021.
-
Abstract
- PURPOSE CNS relapse in patients with diffuse large B-cell lymphoma (DLBCL) is associated with poor prognosis with a median survival of about 2.5 months. Data demonstrating best prophylactic strategy remain controversial and need further definition. PATIENTS AND METHODS We present data of 110 patients with DLBCL treated with standard systemic therapy divided into four groups based on primary CNS prophylaxis strategy and CNS International Prognostic Index (IPI) risk categories. We compared their 3-year CNS relapse rate and overall survival in each group. RESULTS The CNS prophylaxis strategy consisted of intrathecal (IT) methotrexate (MTX) in group 1, high-dose (HD) MTX in group 2, combination IT and HD MTX in group 3, and IT and/or HD MTX with intensive chemotherapy in group 4. At 3 years, CNS relapse rate was 8.6% (4/46), 8.3% (1/12), 4.8% (2/42), and 18% (2/11) in groups 1-4 ( P = .64), respectively. According to CNS IPI, the CNS relapse rate was 16.6%, 10.1%, and 0% in high-, intermediate-, and low-risk groups, respectively. The 3-year overall survival rate was 69%, 75%, 80%, and 45% in groups 1-4 ( P = .71), respectively. CONCLUSION Our study while did not find statistical significance did indicate a lower incidence of CNS relapse with the addition of systemic HD MTX to IT MTX in the high-risk DLBCL population.
- Subjects :
- Oncology
Cancer Research
medicine.medical_specialty
Hematologic Malignancies
MEDLINE
Central Nervous System Neoplasms
03 medical and health sciences
0302 clinical medicine
Text mining
Risk groups
Internal medicine
medicine
Humans
In patient
B-Lymphocytes
business.industry
ORIGINAL REPORTS
CNS Prophylaxis
medicine.disease
Lymphoma
030220 oncology & carcinogenesis
B-Cell Non-Hodgkin Lymphoma
Lymphoma, Large B-Cell, Diffuse
Neoplasm Recurrence, Local
business
Real world data
Follow-Up Studies
030215 immunology
Subjects
Details
- ISSN :
- 26878941
- Database :
- OpenAIRE
- Journal :
- JCO Global Oncology
- Accession number :
- edsair.doi.dedup.....0de3ad88fdc6a3463118528c1f3b5c38