Assessing Different CNS Prophylaxis Strategies Across Risk Groups in Patients With DLBCL

Central nervous system (CNS) relapse in patients with high-risk diffuse large B-cell lymphoma (DLBCL) may be attenuated with the use of certain prophylactic strategies, according to a study published in JCO Global Oncology.

In this study, researchers assessed data from 110 patients with DLBCL who were treated with standard systemic therapy. The population of interest was divided into four groups based on primary CNS prophylaxis strategy and CNS International Prognostic Index (IPI) risk categories. The CNS prophylaxis strategy employed in this study comprised intrathecal (IT) methotrexate (MTX) in group one, high-dose (HD) MTX in group two, combination IT and HD MTX in group three, and IT and/or HD MTX with intensive chemotherapy in group four.

According to the results, at three years, CNS relapse rates were 8.6%, 8.3%, 4.8%, and 18% in the four respective groups. The CNS IPI showed the CNS relapse rate to be 16.6%, 10.1%, and 0% in high-, intermediate-, and low-risk groups, respectively. Overall, the three-year overall survival rate was 69%, 75%, 80%, and 45% in the four respective groups.

Our study while did not find statistical significance did indicate a lower incidence of CNS relapse with the addition of systemic HD MTX to IT MTX in the high-risk DLBCL population,” the researchers concluded.