All rights reserved. Integration of cell of origin into the clinical CNS International Prognostic Index improves CNS relapse prediction in DLBCL. Again, CNS relapse is not specifically indicated as an outcome measure, although it might be possible to assess this from trial data. Home » News » Conference Coverage » The Annual Congress of the European Hematology Association (EHA) » EHA25 Virtual Congress. Prevention of CNS relapse in diffuse large B-cell lymphoma. However, this trial does not appear to be assessing the association of ctDNA with CNS relapse. CancerTherapyAdvisor.com is a free online resource that offers oncology healthcare professionals a comprehensive knowledge base of practical oncology information and clinical tools to assist in making the right decisions for their patients. 0000097774 00000 n 0000289550 00000 n However, some studies have shown the molecular subtypes of activated B-cell and non—germinal center B-cell–type DLBCL have been associated with an increased risk of CNS relapse.10, Recently, the contribution of the cell of origin (COO) to the risk of CNS relapse has been investigated using gene expression profiling of tissue samples from patients with previously untreated CD20-positive DLBCL who enrolled in the GOYA study, a randomized phase III trial (NCT01287741) comparing the safety and efficacy of CHOP in combination with either rituximab or obinutuzumab (Gazyva).11In this analysis, dual expression of MYC and BCL2 was not associated with an increased risk of CNS relapse. “Regardless of the score, if we have what we call a double-hit lymphoma or a triple-hit lymphoma, we do CNS prophylaxis,” she said. J Clin Oncol. However, the largest study supporting this observation is the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL), which found, in a multivariate analysis, that the addition of rituximab to the CHOP regimen … 0000258828 00000 n Because CNS relapse takes a median of 6 to 8 months to develop, “there is rationale to deliver prophylactic, CNS-directed therapy as early as possible to high-risk patients,” Matthew Wilson, MD, BSc, MRCP, of the Beatson West of Scotland Cancer Centre in the United Kingdom, and lead author and presenter, said. 0000233610 00000 n Univariate and multivariate analyses were conducted to determine risk factors for delay of R-CHOP cycles. You’ve read {{metering-count}} of {{metering-total}} articles this month. Risk Factors for CNS Recurrence of DLBCL. CNS relapse in patients with DLBCL treated with lenalidomide plus R-CHOP (R2CHOP): analysis from two phase 2 studies. 0000264016 00000 n • CNS prophylaxis should improve survival figures in patients with high-risk DLBCL. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): B-cell lymphomas. The use of i-HD-MTX was  significantly independently associated with delay in R-CHOP in the multivariate analysis (odds ratio [OR], 3.06; 95% CI, 1.62-5.77). Scoring systems have been developed to assess the risk of CNS relapse in DLBCL. 0000265465 00000 n This multicenter, retrospective study included 334 patients with DLBCL who received HD-MTX intercalated between R-CHOP cycles (i-HD-MTX) or HD-MTX given at the end of R-CHOP (EOT). There is insufficient evidence to suggest that bone or bone marrow involvement confers sufficiently increased risk in isolation to offer CNS prophylaxis. 0000172856 00000 n Diffuse large B-cell lymphoma (DLBCL) is the most common adult non-Hodgkin lymphoma (NHL), accounting for about a third of all cases.1The World Health Organization classification recognizes over 15 subtypes of DLBCL, based on the primary tumor site, specific genetic alterations, or association with specific viruses.2, DLBCL is considered potentially curable, and although central nervous system (CNS) involvement is infrequently discovered at diagnosis, it often occurs within months of initial disease identification. 0000265040 00000 n Inpatient stay was longer by a median of 1 day in the i-HD-MTX group compared with the EOT group. After patients receive that single dose of methotrexate, they are evaluated for additional treatment with high-dose methotrexate, taking into account their renal function, comorbidities, and fitness. 0000258295 00000 n 2011;12(13):1258-1266. doi: 10.1016/S1470-2045(11)70140 1. Close more info about Timing of MD-MTX Prophylaxis for DLBCL CNS Relapse Evaluated, The Annual Congress of the European Hematology Association (EHA), Inotuzumab Ozogamicin Plus R-CVP for Patients With DLBCL Who Are Ineligible for R-CHOP, Close Monitoring, Full-Time Caregiver Recommended for 30 Days After CAR-T Therapy, Patient Relapse Time After Auto-HCT in Chemosensitive DLBCL Does Not Appear to Influence PFS, High dose methotrexate CNS prophylaxis in diffuse large b-cell lymphoma (DLBCL): a multicentre analysis of toxicity and impact on R-CHOP delivery, Treatment Modifications Common Among Older Patients With cHL.