XVI. CNS prophylaxis in aggressive lymphomas: for whom and how

Benevolo, Giulia; Chiappella, Annalisa; Vitolo, Umberto

doi:10.1002/hon.2074

Cited by 1 publication

(2 citation statements)

References 15 publications

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“… showed that DLBCL of the breast also carries a high risk of CNS relapse. Other anatomical sites, such as the kidneys, paranasal sinuses, hard palate, orbit, dura and paravertebral lesions, have also been associated with increased risk of CNS involvement . Also, a recent retrospective study of 117 DLBCL patients treated with R‐EPOCH showed that genitourinary involvement was a major risk factor correlating with CNS relapse .…”

Section: Risk Factorsmentioning

confidence: 99%

“…CNS involvement is frequently suspected with the presence of neurological and behavioral symptoms. Standard diagnostic studies used in evaluating patients at high risk for CNS disease or those with suspected CNS involvement include neuroimaging and cytological examination of cerebrospinal fluid (CSF) . However, conventional CSF cytology is able to reveal malignant lymphoid cells in only 40% of patients with suspected CNS dissemination .…”

Section: Risk Factorsmentioning

confidence: 99%

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Central nervous system prophylaxis in diffuse large B‐cell lymphoma

Zahid

Khan

Hashmi

et al. 2016

European J of Haematology

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Central nervous system (CNS) involvement with diffuse large B-cell lymphoma (DLBCL) is a relatively uncommon manifestation; with most cases of CNS involvement occuring during relapse after primary therapy. CNS dissemination typically occurs early in the disease course and is most likely present subclinically at the time of diagnosis in many patients who later relapse in the CNS. CNS relapse in these patients is associated with poor outcomes. Based on a CNS relapse rate of 5% in DLBCL and weighing the benefits against the toxicities, universal application of CNS prophylaxis is not justified. The introduction of rituximab has significantly reduced the incidence of CNS relapse in DLBCL. Different studies have employed other agents for CNS prophylaxis, such as intrathecal chemotherapy and high-dose systemic agents with sufficient CNS penetration. If CNS prophylaxis is to be given, it should be preferably administered during primary chemotherapy. However, there is no strong evidence that supports any single approach for CNS prophylaxis. In this review, we outline different strategies of administering CNS prophylaxis in DLBCL patients reported in literature and discuss their advantages and drawbacks.

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Section: Risk Factorsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%