Incidence and risk factors for central nervous system relapse in patients with primary mediastinal large B-cell lymphoma in the rituximab era.
Humans
Rituximab
/ therapeutic use
Incidence
Central Nervous System Neoplasms
/ drug therapy
Neoplasm Recurrence, Local
/ pathology
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Risk Factors
Cyclophosphamide
Vincristine
Doxorubicin
Chronic Disease
Central Nervous System
/ pathology
Lymphoma, B-Cell
/ drug therapy
Lymphoma, Large B-Cell, Diffuse
/ pathology
aggressive lymphoma
central nervous system
large cell
primary mediastinal
relapse
Journal
Hematological oncology
ISSN: 1099-1069
Titre abrégé: Hematol Oncol
Pays: England
ID NLM: 8307268
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
revised:
15
09
2022
received:
02
05
2022
accepted:
22
10
2022
pubmed:
1
11
2022
medline:
3
2
2023
entrez:
31
10
2022
Statut:
ppublish
Résumé
Central nervous system (CNS) involvement is rare in primary mediastinal large B-cell lymphoma (PMLBCL). We aimed to evaluate the incidence of CNS relapse as first treatment failure event and the effect of the induction chemotherapy regimen, central nervous system - international prognostic index (CNS-IPI) and other clinical and laboratory variables on the risk of CNS relapse in 564 PMLBCL patients treated with immunochemotherapy. Only 17 patients (3.0%) received CNS prophylaxis. During a 55-month median follow-up only 8 patients experienced CNS relapse as first event, always isolated. The 2-year cumulative incidence of CNS relapse (CI-CNSR) was 1.47% and remained unchanged thereafter. The CI-CNSR was not affected by the chemotherapy regimen (R-CHOP or R-da-EPOCH). None of the established International Prognostic Index factors for aggressive lymphomas predicted CNS relapse in PMLBCL. The 2-year CI-CNSR in patients with versus without kidney involvement was 13.3% versus 0.96% (p < 0.001); 14.3% versus 1.13% with versus without adrenal involvement (p < 0.001); and 10.2% versus 0.97% with versus without either kidney or adrenal involvement. CNS-IPI was also predictive (2-year CI-CNSR in high-risk vs. intermediate/low-risk: 10.37% vs. 0.84%, p < 0.001). However, this association may be driven mainly by kidney and/or adrenal involvement. In conclusion, in PMLBCL, CNS relapse is rare and appears to be strongly associated with kidney and/or adrenal involvement.
Substances chimiques
Rituximab
4F4X42SYQ6
Cyclophosphamide
8N3DW7272P
Vincristine
5J49Q6B70F
Doxorubicin
80168379AG
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
97-107Informations de copyright
© 2022 John Wiley & Sons Ltd.
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