ArticleBlood advances2021
Efficacy and safety of prophylactic high-dose MTX in high-risk DLBCL: a treatment intent-based analysis.
Article in Blood advances, 2021. 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 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Pooled it
- IELSG30 phase 2 trial: intravenous and intrathecal CNS prophylaxis in primary testicular diffuse large B-cell lymphoma.Blood advances · 2024Trial
- Article
- Clinical, Biological, and Treatment-Related Predictors of Central Nervous System Relapse in Diffuse Large B-Cell Lymphoma: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Protocol digest of a randomized phase III study of pola-R-CHP/high-dose methotrexate/IT vs. pola-R-CHP/IT for newly diagnosed diffuse large B-cell lymphoma with high risk of central nervous system relapse: JCOG2201 (PREMIER).Japanese journal of clinical oncology · 2026Article
- CNS prophylaxis with high-dose methotrexate and intrathecal chemotherapy improves survival in DLBCL with high CNS relapse risk.International journal of hematology · 2026Article
- Delayed Methotrexate Elimination Following High-dose Methotrexate Prophylaxis in High-risk Diffuse Large B-cell Lymphoma.Internal medicine (Tokyo, Japan) · 2025Article
- Risk of central nervous system versus systemic relapse in patients with diffuse large B-cell lymphoma treated with R-CHOP: What should we focus on?HemaSphere · 2025Article
- Central Nervous System Prophylaxis Approach in High-Risk Diffuse Large B-Cell Lymphoma Patients: A Retrospectively Collected, Single-Center Cohort Analysis.Cancer medicine · 2025Article
- Treatments and Outcomes of Newly Diagnosed CD5-Positive Diffuse Large B-Cell Lymphoma: A Multi-Institutional Observational Study.Hematological oncology · 2025Observational
- Article
- The CNS relapse in T-cell lymphoma index predicts CNS relapse in patients with T- and NK-cell lymphomas.Blood advances · 2024Article
- Comparison of standardized prophylactic high-dose and intrathecal methotrexate for DLBCL with a high risk of CNS relapse.International journal of hematology · 2024Article
- Recent updates on central nervous system prophylaxis in patients with high-risk diffuse large B-cell lymphoma.Experimental hematology & oncology · 2024Review
- Central nervous system relapse after combination therapy including polatuzumab vedotin in patients with diffuse large B-cell lymphoma.Leukemia research reports · 2024Article
- Review
- An Aged/Autoimmune B-cell Program Defines the Early Transformation of Extranodal Lymphomas.Cancer discovery · 2023Article
- SOHO State of the Art Updates and Next Questions: Prophylaxis and Management of Secondary CNS Lymphoma.Clinical lymphoma, myeloma & leukemia · 2022Review
- Feasibility of high-dose methotrexate administered on day 1 of (R)CHOP in aggressive non-Hodgkin lymphomas.Blood advances · 2022Article
- Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options.OncoTargets and therapy · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
15 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite central nervous system (CNS) relapse occurring in >10% of high-risk diffuse large B-cell lymphoma (DLBCL) patients, the role of CNS-directed prophylaxis is controversial in the absence of randomized controlled trials. In this retrospective study, we aimed to evaluate the safety and efficacy of prophylactic high-dose methotrexate (HD-MTX) on CNS relapse and survival outcomes in 258 newly diagnosed R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-treated high-risk DLBCL patients, based on the initial treatment intent (ITT) of the physician on the use of prophylactic HD-MTX. Patients were classified into an ITT HD-MTX group (n = 128) and a non-ITT HD-MTX group (n = 130). The CNS relapse rate was not significantly different between these groups, with 2-year CNS relapse rates of 12.4% and 13.9%, respectively (P = 0.96). Three-year progression-free survival and overall survival rates in the ITT HD-MTX and non-ITT HD-MTX groups were 62.4% vs 64.5% (P = 0.94) and 71.7% vs 71.4% (P = 0.7), respectively. Also, propensity score-matched analyses showed no significant differences in the time-to-CNS-relapse, progression-free survival, or overall survival. The ITT HD-MTX group showed a higher incidence of grade ≥ 3 oral mucositis and elevated alanine aminotransferase. Prophylactic HD-MTX does not improve CNS relapse rate or survival outcomes in high-risk DLBCL patients, and it is accompanied by increased toxicities.
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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.