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Use CNS Prophylaxis Selectively in These Patients

Am J Hematol; ePub 2017 Aug 17; Malecek, et al

Publish date:

It might be reasonable to use central nervous system (CNS) prophylaxis more selectively in certain patients with non-Hodgkin lymphoma (NHL), according to a study involving 223 individuals. Participants had NHL and received front-line infusional etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab as front-line therapy. Investigators looked at overall and progression-free survival, as well as CNS progression. Among the results:

  • 72% of patients had DLBCL.
  • Overall, 6% experienced CNS relapse.
  • 37% were treated with CNS prophylaxis.
  • Overall and progression-free survival rates were similar in patients who did and did not receive CNS prophylaxis.
  • The same was seen for CNS relapse.
  • Patients whose serum lactate dehydrogenase was greater than twice the upper limit of normal at diagnosis were significantly more likely to have CNS relapse.
  • Those with extranodal disease were also much more likely to experience such.

Citation:

Malecek M, Petrich A, Rozell S, et al. Frequency, risk factors, and outcomes of central nervous system relapse in lymphoma patients treated with dose-adjusted EPOCH plus rituximab. [Published online ahead of print August 17, 2017]. Am J Hematol. doi:10.1002/ajh.24864.

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