Journal article

Outcomes of synchronous systemic and central nervous system (CNS) involvement of diffuse large B-cell lymphoma are dictated by the CNS disease: a collaborative study of the Australasian Lymphoma Alliance

Joel C Wight, Mimi Yue, Colm Keane, Anna Johnston, Kim Linton, Collin Chin, Shin Hnin Wai, Dipti Talaulikar, Robin Gasiorowski, Chan Yoon Cheah, Gareth P Gregory, Michael Dickinson, Adrian Minson, Caitlin Coombes, Matthew Ku, Stephanie Lam, Eliza A Hawkes

British Journal of Haematology | WILEY | Published : 2019

Abstract

De novo diffuse large B-cell lymphoma (DLBCL) presenting with synchronous central nervous system (CNS) and systemic disease (synDLBCL) is not well described and is excluded from clinical trials. We performed a retrospective analysis of 80 synDLBCL patients treated across 10 Australian and UK centres. Of these patients, 96% had extranodal systemic disease. CNS-directed treatment with combination intravenous cytarabine and high-dose methotrexate ("CNS-intensive") (n = 38) was associated with favourable survival outcomes compared with "CNS-conservative" strategies such as intravenous high-dose methotrexate monotherapy, intrathecal therapy and/or radiotherapy (2-year progression-free survival [P..

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