Journal article

A multicentre retrospective comparison of central nervous system prophylaxis strategies among patients with high-risk diffuse large B-cell lymphoma.

CY Cheah, KE Herbert, K O'Rourke, GA Kennedy, A George, PL Fedele, M Gilbertson, SY Tan, DS Ritchie, SS Opat, HM Prince, M Dickinson, K Burbury, M Wolf, EH Januszewicz, CS Tam, DA Westerman, DA Carney, SJ Harrison, JF Seymour

British Journal of Cancer | Published : 2014

Abstract

Central nervous system (CNS) relapse in diffuse large B-cell lymphoma (DLBCL) is a devastating complication; the optimal prophylactic strategy remains unclear. We performed a multicentre, retrospective analysis of patients with DLBCL with high risk for CNS relapse as defined by two or more of: multiple extranodal sites, elevated serum LDH and B symptoms or involvement of specific high-risk anatomical sites. We compared three different strategies of CNS-directed therapy: intrathecal (IT) methotrexate (MTX) with (R)-CHOP 'group 1'; R-CHOP with IT MTX and two cycles of high-dose intravenous (IV) MTX 'group 2'; dose-intensive systemic antimetabolite-containing chemotherapy (Hyper-CVAD or CODOXM/..

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