ArticleBlood2022
Single-route CNS prophylaxis for aggressive non-Hodgkin lymphomas: real-world outcomes from 21 US academic institutions.
Article in Blood, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- The Efficacy and Toxicity of CNS Prophylaxis in Diffuse Large B-Cell Lymphoma (CLSG-CNS-01): A Randomized, Multicenter, Prospective Phase 3 Trial.Hematological oncology · 2026Trial
- Trial
- IELSG30 phase 2 trial: intravenous and intrathecal CNS prophylaxis in primary testicular diffuse large B-cell lymphoma.Blood advances · 2024Trial
- Central nervous system relapse in younger patients with diffuse large B-cell lymphoma: a LYSA and GLA/DSHNHL analysis.Blood advances · 2023Trial
- Central nervous system recurrence of diffuse large B-cell lymphoma - risk stratification and prophylaxis.Hematology, transfusion and cell therapy · 2026Review
- Diffuse Large B-Cell Lymphoma: From Molecular Stratification to Precision Immunotherapy.Cells · 2026Review
- Prognosis and treatment of plasmablastic lymphoma in the United States: a multicenter retrospective study.Blood cancer journal · 2026Article
- Current treatment algorithm: diffuse large B cell lymphoma.Blood cancer journal · 2026Review
- Use of a Cystatin C-Based GFR Equation in a Population Pharmacokinetic Model of Methotrexate Clearance in Adult Patients with Lymphoma.Clinical pharmacokinetics · 2026Article
- Prognosis and Treatment of Plasmablastic Lymphoma in the United States: A Multicenter Retrospective Study.Research square · 2025Article
- 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
- Identification of genomic biomarkers of disease progression and survival in primary CNS lymphoma.Blood advances · 2025Article
- Incidence and characterization of secondary CNS lymphoma in 1972 patients with DLBCL: a Danish nationwide cohort study.Blood advances · 2025Article
- Low Rate of Central Nervous System Relapse of Diffuse Large B-Cell Lymphoma Despite Limited Use of Intrathecal Prophylaxis.Journal of hematology · 2025Article
- Outcome of patients with diffuse large B-cell lymphoma and testicular involvement - real world data.Annals of hematology · 2025Article
- Successful Treatment of Methotrexate-associated Lymphoproliferative Disorder with the Pola-R-CHP Regimen.Internal medicine (Tokyo, Japan) · 2025Article
- Biological Findings and Clinical Outcomes in Patients Treated With R-CHOP Plus High-Dose Methotrexate as First-Line Therapy in Large B-Cell Lymphoma With Testis Involvement.European journal of haematology · 2025Article
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53 authors.
Funding
Abstract
Prophylaxis is commonly used to prevent central nervous sy stem (CNS) relapse in diffuse large B-cell lymphoma (DLBCL), with no clear standard of care. We retrospectively evaluated 1162 adult patients across 21 US academic centers with DLBCL or similar histologies who received single-route CNS prophylaxis as part of frontline therapy between 2013 and 2019. Prophylaxis was administered intrathecally(IT) in 894 (77%) and using systemic high-dose methotrexate (HD-MTX) in 236 (20%); 32 patients (3%) switched route due to toxicity and were assessed separately. By CNS-International Prognostic Index (IPI), 18% were considered low-risk, 51% moderate, and 30% high. Double-hit lymphoma (DHL) was confirmed in 243 of 866 evaluable patients (21%). Sixty-four patients (5.7%) had CNS relapse after median 7.1 months from diagnosis, including 15 of 64 (23%) within the first 6 months. There was no significant difference in CNS relapse between IT and HD-MTX recipients (5.4% vs 6.8%, P = .4), including after propensity score matching to account for differences between respective recipient groups. Weighting by CNS-IPI, expected vs observed CNS relapse rates were nearly identical (5.8% vs 5.7%). Testicular involvement was associated with high risk of CNS relapse (11.3%) despite most having lower CNS-IPI scores. DHL did not significantly predict for CNS relapse after single-route prophylaxis, including with adjustment for treatment regimen and other factors. This large study of CNS prophylaxis recipients with DLBCL found no significant difference in CNS relapse rates between routes of administration. Relapse rates among high-risk subgroups remain elevated, and reconsideration of prophylaxis strategies in DLBCL is of critical need.
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