Characteristics, management and outcome of DLBCL patients, presenting with simultaneous systemic and CNS disease at diagnosis: A retrospective multicenter study.
Adult
Aged
Aged, 80 and over
Anthracyclines
/ administration & dosage
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Central Nervous System Neoplasms
/ diagnosis
Cytarabine
/ administration & dosage
Disease-Free Survival
Female
Humans
Lymphoma, Large B-Cell, Diffuse
/ diagnosis
Male
Methotrexate
/ administration & dosage
Middle Aged
Survival Rate
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
18
02
2019
revised:
08
06
2019
accepted:
12
06
2019
pubmed:
19
6
2019
medline:
11
3
2020
entrez:
19
6
2019
Statut:
ppublish
Résumé
The incidence of systemic diffuse large B cell lymphoma (DLBCL) concurrently involving the central nervous system (CNS) at diagnosis, is very low and data regarding the clinical course of these patients are scarce. We investigated characteristics, efficacy of treatment regimens including consolidative autologous stem cell transplantation and outcome of patients presenting with concomitant systemic and CNS DLBCL. The records of 44 patients, diagnosed between 2004 and 2017, who fulfilled the inclusion criteria, were retrospectively reviewed. CNS involvement was diagnosed as solely parenchymal in 41%, solely leptomeningeal in 43%, and paranchymal with leptomeningeal in 11% of the patients. Induction regimens were anthracycline-based combined with high-dose methotrexate (HD-MTX) in 80% (n = 35) of patients, anthracycline-based combined with intrathecal MTX in 3, cytarabine-based (without antracyclines) in 2, HD-MTX in 1 and palliative in three. Five of 41 patients treated with chemotherapy died of treatment-related toxicity, all due to infections. Nineteen patients had consolidative autologous transplantation. Overall response rate following induction was 80% (complete responses 66% and partial responses 15%). All relapses (n = 11) occurred within less than 2 years. Within a median follow-up of 26.8 months, 3-years projected overall survival (OS) and progression free survival rates for the entire cohort were 56% ± 8.3 and 42% ± 8.9, respectively. In multivariate analysis, RCHOP-HD MTX-based induction [HR = 0.228, (0.054-0.964)], administration of 3.5 g/m
Substances chimiques
Anthracyclines
0
Cytarabine
04079A1RDZ
Methotrexate
YL5FZ2Y5U1
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
992-1001Informations de copyright
© 2019 Wiley Periodicals, Inc.
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