Central Nervous System Prophylaxis for Diffuse Large B-Cell Lymphoma

Adding high-dose methotrexate to front-line therapy limited CNS relapses in patients with high-risk DLBCL.

Leptomeningeal or parenchymal central nervous system (CNS) relapse is a dreaded, often rapidly fatal event for patients with diffuse large B-cell lymphoma (DLBCL). Clinical features at DLBCL presentation can identify patients who are at especially high risk for CNS relapse (JW Oncol Hematol Feb 19 2008). However, the efficacy of intrathecal chemotherapy prophylaxis is not clear, and prospective evidence to guide intrathecal or systemic CNS prophylaxis is lacking.

Investigators at Massachusetts General Hospital retrospectively assessed the value of intravenous methotrexate in 65 patients who had newly diagnosed DLBCL and risk factors for CNS recurrence (2 or more extranodal sites; elevated lactate dehydrogenase; or a high-risk disease site su…

Reviewing Author

Michael E. Williams, MD

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee

Michael E. Williams, MD

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee