Evidence map›Paper›PMID 40859046›Full record

ArticleInternational journal of hematology2026

CNS prophylaxis with high-dose methotrexate and intrathecal chemotherapy improves survival in DLBCL with high CNS relapse risk.

Yuri Miyazawa, Akihiko Yokohama, Takuma Ishizaki, Takayuki Saitoh, Akio Saito, Kohtaro Toyama, Takeki Mitsui, Kayoko Murayama, Hidemi Ogura, Norifumi Tsukamoto and 1 more

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Article in International journal of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yuri MiyazawaDepartment of Hematology, Gunma University Graduate School of Medicine, 3-39-15, Showa-Machi, Maebashi, Gunma, 371-8511, Japan. yuri.miyazawa@gunma-u.ac.jp.ORCID http://orcid.org/0009-0008-8754-345X
Akihiko YokohamaDivision of Blood Transfusion Service, Gunma University Hospital, Maebashi, Gunma, Japan.
Takuma IshizakiDepartment of Hematology, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan.
Takayuki SaitohDepartment of Laboratory Sciences, Gunma University Graduate School of Health Science, Maebashi, Gunma, Japan.
Akio SaitoDepartment of Hematology, NHO Shibukawa Medical Center, Shibukawa, Gunma, Japan.
Kohtaro ToyamaDepartment of Hematology, Fujioka General Hospital, Fujioka, Gunma, Japan.
Takeki MitsuiDivision of Internal Medicine, Usui Hospital, Annaka, Gunma, Japan.
Kayoko MurayamaDivision of Hematology, Gunma Prefectural Cancer Center, Ota-Shi, Gunma, Japan.
Hidemi OguraDepartment of Hematology, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan.
Norifumi TsukamotoDivision of Internal Medicine, Ninosawa Hospital, Takasaki, Gunma, Japan.
Hiroshi HandaDepartment of Hematology, Gunma University Graduate School of Medicine, 3-39-15, Showa-Machi, Maebashi, Gunma, 371-8511, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCentral nervous system (CNS) prophylaxis is recommended for patients with diffuse large B-cell lymphoma (DLBCL) who are at high risk of CNS relapse. This study aimed to determine the impact of CNS prophylaxis on CNS relapse rates and overall survival (OS) in this patient population, as well as the optimal method for CNS prophylaxis.

methodsThis was a retrospective analysis of 178 patients with DLBCL at high risk of CNS relapse who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) or its derivatives with (N = 60) or without (N = 118) CNS prophylaxis.

resultsThe 2-year CNS relapse rate was 17.6% in the all-prophylaxis group (HD-MTX 17.4%, IT 48.1%, and HD-MTX + IT 6.2%) and 13.0% in the non-prophylaxis group, with no significant difference between groups. However, HD-MTX + IT decreased the risk of CNS relapse. After a median follow-up of 72.8 months, HD-MTX + IT addition significantly improved the 5-year OS (HD-MTX 73.5%, IT 44.4%, HD-MTX + IT 93.2%; non-prophylaxis group 58.0%; p = 0.013). This advantage was maintained in the multivariate analysis (hazard ratio: 0.160; 95% confidence interval: 0.039-0.663; p = 0.012).

conclusionsCNS prophylaxis with HD-MTX + IT improved the prognosis of patients with DLBCL at high risk of CNS relapse.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCentral Nervous System NeoplasmsLymphoma, Large B-Cell, DiffuseMethotrexateAdultAgedAged, 80 and overCyclophosphamideDoxorubicinFemaleHumansInjections, SpinalMaleMiddle AgedPrednisoneRecurrenceCyclophosphamideDoxorubicinMethotrexatePrednisoneR-CHOP protocolRituximabVincristineCentral nervous system prophylaxisDiffuse large B-cell lymphomaHigh-dose methotrexateHigh-risk central nervous systemOverall survival

Identifiers

PMID40859046

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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.