CNS disease in younger patients with aggressive B-cell lymphoma: an analysis of patients treated on the Mabthera International Trial and trials of the German High-Grade Non-Hodgkin Lymphoma Study Group
(2012) In Annals of Oncology 23(5). p.1267-1273- Abstract
- To describe incidence, risk factors, and influence of treatment on occurrence of central nervous system (CNS) relapse or progression in younger patients with aggressive B-cell lymphoma. We analyzed 2210 patients with aggressive B-cell lymphoma treated on various studies for CNS relapse/progression. Treatment consisted of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) +/- etoposide. Six hundred and twenty patients also received rituximab. CNS prophylaxis was intrathecal methotrexate on High-CHOEP and MegaCHOEP phase III studies if upper neck, head, bone marrow, or testes were involved. Fifty-six of 2196 patients (2.6%) developed CNS disease. It occurred early (median 7.0 months), median survival was 5.0 months. Patients... (More)
- To describe incidence, risk factors, and influence of treatment on occurrence of central nervous system (CNS) relapse or progression in younger patients with aggressive B-cell lymphoma. We analyzed 2210 patients with aggressive B-cell lymphoma treated on various studies for CNS relapse/progression. Treatment consisted of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) +/- etoposide. Six hundred and twenty patients also received rituximab. CNS prophylaxis was intrathecal methotrexate on High-CHOEP and MegaCHOEP phase III studies if upper neck, head, bone marrow, or testes were involved. Fifty-six of 2196 patients (2.6%) developed CNS disease. It occurred early (median 7.0 months), median survival was 5.0 months. Patients with age-adjusted International Prognostic Index (aaIPI) 0 or 1 treated with rituximab showed a low risk for CNS disease (2-year rates: 0% or 0.5%), and rituximab decreased the risk (relative risk 0.3, 95% confidence interval 0.1-0.9, P = 0.029). Patients with aaIPI 2 or 3 showed a moderate risk (4.2%-9.7%) and no significant reduction of CNS disease with rituximab. CNS prophylaxis was of no significant benefit. In younger patients with aaIPI 0 or 1, CNS relapse/progression is very rare; in patients with aaIPI 2 or 3, the risk is higher (up to 10%) and requires new diagnostic strategies and treatment. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2551557
- author
- Schmitz, N. ; Zeynalova, S. ; Glass, B. ; Kaiser, U. ; Cavallin-Ståhl, Eva LU ; Wolf, M. ; Haenel, M. ; Loeffler, M. ; Truemper, L. and Pfreundschuh, M.
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- aggressive lymphoma, central nervous system relapse, DLBCL, rituximab
- in
- Annals of Oncology
- volume
- 23
- issue
- 5
- pages
- 1267 - 1273
- publisher
- Oxford University Press
- external identifiers
-
- wos:000303336400027
- scopus:84860448201
- pmid:21989328
- ISSN
- 1569-8041
- DOI
- 10.1093/annonc/mdr440
- language
- English
- LU publication?
- yes
- id
- f17bc64f-8389-4a41-863b-609a94253fd4 (old id 2551557)
- date added to LUP
- 2016-04-01 14:43:27
- date last changed
- 2022-04-14 19:23:32
@article{f17bc64f-8389-4a41-863b-609a94253fd4, abstract = {{To describe incidence, risk factors, and influence of treatment on occurrence of central nervous system (CNS) relapse or progression in younger patients with aggressive B-cell lymphoma. We analyzed 2210 patients with aggressive B-cell lymphoma treated on various studies for CNS relapse/progression. Treatment consisted of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) +/- etoposide. Six hundred and twenty patients also received rituximab. CNS prophylaxis was intrathecal methotrexate on High-CHOEP and MegaCHOEP phase III studies if upper neck, head, bone marrow, or testes were involved. Fifty-six of 2196 patients (2.6%) developed CNS disease. It occurred early (median 7.0 months), median survival was 5.0 months. Patients with age-adjusted International Prognostic Index (aaIPI) 0 or 1 treated with rituximab showed a low risk for CNS disease (2-year rates: 0% or 0.5%), and rituximab decreased the risk (relative risk 0.3, 95% confidence interval 0.1-0.9, P = 0.029). Patients with aaIPI 2 or 3 showed a moderate risk (4.2%-9.7%) and no significant reduction of CNS disease with rituximab. CNS prophylaxis was of no significant benefit. In younger patients with aaIPI 0 or 1, CNS relapse/progression is very rare; in patients with aaIPI 2 or 3, the risk is higher (up to 10%) and requires new diagnostic strategies and treatment.}}, author = {{Schmitz, N. and Zeynalova, S. and Glass, B. and Kaiser, U. and Cavallin-Ståhl, Eva and Wolf, M. and Haenel, M. and Loeffler, M. and Truemper, L. and Pfreundschuh, M.}}, issn = {{1569-8041}}, keywords = {{aggressive lymphoma; central nervous system relapse; DLBCL; rituximab}}, language = {{eng}}, number = {{5}}, pages = {{1267--1273}}, publisher = {{Oxford University Press}}, series = {{Annals of Oncology}}, title = {{CNS disease in younger patients with aggressive B-cell lymphoma: an analysis of patients treated on the Mabthera International Trial and trials of the German High-Grade Non-Hodgkin Lymphoma Study Group}}, url = {{http://dx.doi.org/10.1093/annonc/mdr440}}, doi = {{10.1093/annonc/mdr440}}, volume = {{23}}, year = {{2012}}, }