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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorBobillo Varela, Sabela
dc.contributor.authorJoffe, Erel
dc.contributor.authorSermer, David
dc.contributor.authorMondello, Patrizia
dc.contributor.authorGhione, Paola
dc.contributor.authorCaron, Philip C.
dc.date.accessioned2022-02-25T13:55:10Z
dc.date.available2022-02-25T13:55:10Z
dc.date.issued2021-06-16
dc.identifier.citationBobillo S, Joffe E, Sermer D, Mondello P, Ghione P, Caron PC, et al. Prophylaxis with intrathecal or high-dose methotrexate in diffuse large B-cell lymphoma and high risk of CNS relapse. Blood Cancer J. 2021 Jun 16;11:113.
dc.identifier.issn2044-5385
dc.identifier.urihttp://hdl.handle.net/11351/7097
dc.descriptionB-cell lymphoma; Disease-free survival
dc.description.abstractAlthough methotrexate (MTX) is the most widely used therapy for central nervous system (CNS) prophylaxis in patients with diffuse large B-cell lymphoma (DLBCL), the optimal regimen remains unclear. We examined the efficacy of different prophylactic regimens in 585 patients with newly diagnosed DLBCL and high-risk for CNS relapse, treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or R-CHOP-like regimens from 2001 to 2017, of whom 295 (50%) received prophylaxis. Intrathecal (IT) MTX was given to 253 (86%) and high-dose MTX (HD-MTX) to 42 (14%). After a median follow-up of 6.8 years, 36 of 585 patients relapsed in the CNS, of whom 14 had received prophylaxis. The CNS relapse risk at 1 year was lower for patients who received prophylaxis than patients who did not: 2% vs. 7.1%. However, the difference became less significant over time (5-year risk 5.6% vs. 7.5%), indicating prophylaxis tended to delay CNS relapse rather than prevent it. Furthermore, the CNS relapse risk was similar in patients who received IT and HD-MTX (5-year risk 5.6% vs. 5.2%). Collectively, our data indicate the benefit of MTX for CNS prophylaxis is transient, highlighting the need for more effective prophylactic regimens. In addition, our results failed to demonstrate a clinical advantage for the HD-MTX regimen.
dc.language.isoeng
dc.publisherSpringer Nature
dc.relation.ispartofseriesBlood Cancer Journal;11
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectCèl·lules B - Tumors - Tractament
dc.subjectCàncer - Recaiguda
dc.subjectSang - Malalties - Diagnòstic
dc.subject.meshLymphoma, Large B-Cell, Diffuse
dc.subject.mesh/drug therapy
dc.subject.meshNeoplasm Recurrence, Local
dc.titleProphylaxis with intrathecal or high-dose methotrexate in diffuse large B-cell lymphoma and high risk of CNS relapse
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1038/s41408-021-00506-3
dc.subject.decslinfoma de células B grandes difuso
dc.subject.decs/farmacoterapia
dc.subject.decsrecurrencia neoplásica local
dc.relation.publishversionhttps://doi.org/10.1038/s41408-021-00506-3
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Bobillo S] Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Department of Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Joffe E, Sermer D, Mondello P, Ghione P, Caron PC] Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
dc.identifier.pmid34135307
dc.identifier.wos000664631700003
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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