Comparison of standardized prophylactic high-dose and intrathecal methotrexate for DLBCL with a high risk of CNS relapse
© 2024. Japanese Society of Hematology..
The efficacy of high-dose methotrexate (HD-MTX) for central nervous system (CNS) relapse prophylaxis in patients with high-risk diffuse large B-cell lymphoma (DLBCL) is controversial. We compared the prophylactic effects of HD-MTX and intrathecal methotrexate (IT-MTX) on CNS relapse in high-risk DLBCL, in a multicenter retrospective study. A total of 132 patients with DLBCL at high risk of CNS relapse who received frontline chemotherapy and IT-MTX from 2003 to 2013 (n = 34) or HD-MTX from 2014 to 2020 (n = 98) were included. After a median follow-up of 52 months (range: 9-174), 11 patients had isolated CNS relapse: six (6.1%) in the HD-MTX group and five (14.7%) in the IT-MTX group. The median time until CNS relapse was 38 months (range: 11-122), and the cumulative incidence of CNS relapse at 3 years was 3.9% in the HD-MTX group and 6.1% in the IT-MTX group (P = 0.93). Similar results were obtained after adjusting for background factors using propensity score-matched analysis (4.5% HD-MTX vs. 7.6% IT-MTX, P = 0.84). The CNS relapse rate in HD-MTX-treated patients was equivalent to that in IT-MTX patients, demonstrating that HD-MTX was not superior to IT-MTX in preventing CNS relapse.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:119 |
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| Enthalten in: |
International journal of hematology - 119(2024), 2 vom: 17. Feb., Seite 164-172 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Akimoto, Masahiro [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 01.02.2024 Date Revised 01.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s12185-023-03700-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367242125 |
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| 100 | 1 | |a Akimoto, Masahiro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of standardized prophylactic high-dose and intrathecal methotrexate for DLBCL with a high risk of CNS relapse |
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| 520 | |a © 2024. Japanese Society of Hematology. | ||
| 520 | |a The efficacy of high-dose methotrexate (HD-MTX) for central nervous system (CNS) relapse prophylaxis in patients with high-risk diffuse large B-cell lymphoma (DLBCL) is controversial. We compared the prophylactic effects of HD-MTX and intrathecal methotrexate (IT-MTX) on CNS relapse in high-risk DLBCL, in a multicenter retrospective study. A total of 132 patients with DLBCL at high risk of CNS relapse who received frontline chemotherapy and IT-MTX from 2003 to 2013 (n = 34) or HD-MTX from 2014 to 2020 (n = 98) were included. After a median follow-up of 52 months (range: 9-174), 11 patients had isolated CNS relapse: six (6.1%) in the HD-MTX group and five (14.7%) in the IT-MTX group. The median time until CNS relapse was 38 months (range: 11-122), and the cumulative incidence of CNS relapse at 3 years was 3.9% in the HD-MTX group and 6.1% in the IT-MTX group (P = 0.93). Similar results were obtained after adjusting for background factors using propensity score-matched analysis (4.5% HD-MTX vs. 7.6% IT-MTX, P = 0.84). The CNS relapse rate in HD-MTX-treated patients was equivalent to that in IT-MTX patients, demonstrating that HD-MTX was not superior to IT-MTX in preventing CNS relapse | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Central nervous system prophylaxis | |
| 650 | 4 | |a Central nervous system relapse | |
| 650 | 4 | |a Diffuse large B-cell lymphoma | |
| 650 | 4 | |a High-dose methotrexate | |
| 650 | 4 | |a Intrathecal methotrexate | |
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| 700 | 1 | |a Miyazaki, Takuya |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Saigusa, Yusuke |e verfasserin |4 aut | |
| 700 | 1 | |a Takeda, Takaaki |e verfasserin |4 aut | |
| 700 | 1 | |a Hibino, Yuto |e verfasserin |4 aut | |
| 700 | 1 | |a Tokunaga, Mayumi |e verfasserin |4 aut | |
| 700 | 1 | |a Ohashi, Takuma |e verfasserin |4 aut | |
| 700 | 1 | |a Matsumura, Ayako |e verfasserin |4 aut | |
| 700 | 1 | |a Teshigawara, Haruka |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Taisei |e verfasserin |4 aut | |
| 700 | 1 | |a Teranaka, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Yuki |e verfasserin |4 aut | |
| 700 | 1 | |a Matsumoto, Kenji |e verfasserin |4 aut | |
| 700 | 1 | |a Hashimoto, Chizuko |e verfasserin |4 aut | |
| 700 | 1 | |a Fujimaki, Katsumichi |e verfasserin |4 aut | |
| 700 | 1 | |a Fujita, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Sakai, Rika |e verfasserin |4 aut | |
| 700 | 1 | |a Fujisawa, Shin |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Hideaki |e verfasserin |4 aut | |
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