Evidence map›Paper›PMID 31621040›Full record

ArticleJournal of neuro-oncology2019

White matter changes in primary central nervous system lymphoma patients treated with high-dose methotrexate with or without rituximab.

Fayez Estephan, Xiaobu Ye, Omar Dzaye, Nina Wagner-Johnston, Lode Swinnen, Douglas E Gladstone, Rich Ambinder, David Olayinka Kamson, Sebastian Lambrecht, Stuart A Grossman and 2 more

Erratum issuedAbstract read
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
  2. Consolidation Regimen and Cerebral Atrophy in Patients With Primary Central Nervous System Lymphoma.International journal of radiation oncology, biology, physics · 2025
    Article
  3. Article
  4. Neurological complications in oncology and their monitoring and management in clinical practice: a narrative review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Review
  5. Article
  6. Article
  7. Association ofNeurology · 2023
    Article
  8. Article
  9. Article
  10. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Fayez EstephanThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Xiaobu YeThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Omar DzayeThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Nina Wagner-JohnstonThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Lode SwinnenThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Douglas E GladstoneThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Rich AmbinderThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
David Olayinka KamsonThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Sebastian LambrechtRussell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stuart A GrossmanThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Doris D M LinRussell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ddmlin@jhmi.edu.
Matthias HoldhoffThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA. mholdho1@jhmi.edu.ORCID http://orcid.org/0000-0002-3285-3484

Funding

Sidney Kimmel Comprehensive Cancer Center P30CA006973
6 · The paper itself

Abstract

purposeWhite matter changes (WMCs) can develop following systemic chemotherapy in patients with primary central nervous system lymphomas (PCNSLs), but the frequency and extent of these changes is not well characterized. This single center retrospective semi-quantitative study was performed to determine the rate, timing and grade of WMC on MRI in adult patients with newly-diagnosed radiotherapy-naïve PCNSL undergoing treatment with high-dose methotrexate (HD-MTX) with or without the addition of rituximab (-R).

methodsSerial MRI scans of consecutive adult PCNSL patients treated with HD-MTX ± R were assessed for WMC comparing the pre-treatment to post-treatment scans utilizing a 0-to-8-point severity scoring system.

resultsForty-seven PCNSL patients treated with either HD-MTX-R (n = 34; median age 66, 50% male) or HD-MTX (n = 13; median age 53, 54% male) were included in the analysis. WMC were detected in 62% (95% CI 46-76%) overall, in 68% of the HD-MTX-R, and in 46% of the HD-MTX group. Among patients with WMC (n = 29), WMC were first detected at an average of 2.8 months from beginning of therapy in the HD-MTX-R versus at 10.7 months in the HD-MTX group. Average WMC non-zero scores when first detected following the start of treatment were 2.5 (± 1.1) in HD-MTX-R and 1.5 (± 0.6) in HD-MTX.

conclusionsDevelopment of WMC in PCNSL patients treated with MTX and MTX-R is common. WMC changes appear to be more frequent, occur earlier and are more extensive in patients treated with HD-MTX-R compared to HD-MTX. Prospective studies are required to determine whether WMC correlate with survival or neurocognitive outcomes.

Indexed as

AdultAgedAntineoplastic Combined Chemotherapy ProtocolsCentral Nervous System NeoplasmsFemaleHumansLymphomaMaleMethotrexateMiddle AgedRetrospective StudiesRituximabWhite MatterMethotrexateRituximabHigh-dose methotrexateLeukoencephalopathyPrimary central nervous system lymphomaRituximabWhite matter changes

Identifiers

PMID31621040

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.