ArticleInternational journal of hematology2024
Comparison of standardized prophylactic high-dose and intrathecal methotrexate for DLBCL with a high risk of CNS relapse.
Article in International journal of hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 3 citations in OpenAlex.
- Intravascular large B-cell lymphoma mimicking an orbital mass lesion and bilateral cavernous sinus syndrome: A case report.Oncology letters · 2026Article
- Delayed Methotrexate Elimination Following High-dose Methotrexate Prophylaxis in High-risk Diffuse Large B-cell Lymphoma.Internal medicine (Tokyo, Japan) · 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
- Poor outcome of older patients with diffuse large B-cell lymphoma after progression.Journal of clinical and experimental hematopathology : JCEH · 2025Article
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Authors and funding
20 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The efficacy of high-dose methotrexate (HD-MTX) for central nervous system (CNS) relapse prophylaxis in patients with high-risk diffuse large B-cell lymphoma (DLBCL) is controversial. We compared the prophylactic effects of HD-MTX and intrathecal methotrexate (IT-MTX) on CNS relapse in high-risk DLBCL, in a multicenter retrospective study. A total of 132 patients with DLBCL at high risk of CNS relapse who received frontline chemotherapy and IT-MTX from 2003 to 2013 (n = 34) or HD-MTX from 2014 to 2020 (n = 98) were included. After a median follow-up of 52 months (range: 9-174), 11 patients had isolated CNS relapse: six (6.1%) in the HD-MTX group and five (14.7%) in the IT-MTX group. The median time until CNS relapse was 38 months (range: 11-122), and the cumulative incidence of CNS relapse at 3 years was 3.9% in the HD-MTX group and 6.1% in the IT-MTX group (P = 0.93). Similar results were obtained after adjusting for background factors using propensity score-matched analysis (4.5% HD-MTX vs. 7.6% IT-MTX, P = 0.84). The CNS relapse rate in HD-MTX-treated patients was equivalent to that in IT-MTX patients, demonstrating that HD-MTX was not superior to IT-MTX in preventing CNS relapse.
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Registered trials
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