CNS prophylaxis for diffuse large B-cell lymphoma

Toby A Eyre; Kerry J Savage; Chan Y Cheah; Tarec C El-Galaly; Katharine L Lewis; Pamela McKay; Matthew R Wilson; Andrew M Evens; Sabela Bobillo; Diego Villa; Matthew J Maurer; Kate Cwynarski; Andrés J M Ferreri

doi:10.1016/S1470-2045(22)00371-0

CNS prophylaxis for diffuse large B-cell lymphoma

Toby A Eyre^*, Kerry J Savage, Chan Y Cheah, Tarec C El-Galaly, Katharine L Lewis, Pamela McKay, Matthew R Wilson, Andrew M Evens, Sabela Bobillo, Diego Villa, Matthew J Maurer, Kate Cwynarski, Andrés J M Ferreri

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

1 Citation (Scopus)

Abstract

CNS relapse in the brain parenchyma, eyes, or leptomeninges is an uncommon but devastating complication of diffuse large B-cell lymphoma. CNS prophylaxis strategies, typically involving intrathecal or high-dose antimetabolites, have been developed in the front-line treatment setting with the aim to reduce this subsequent risk. Clinical and biological features associated with elevated risk are increasingly well defined and are discussed in this Review. This Review summarises both the historical and current developments in this challenging field, provides a nuanced discussion regarding current reasons for and against standard prophylactic measures, outlines evidence for the timing of prophylactic measures when delivered, and reflects on possible future developments.

Original language	English
Journal	The Lancet Oncology
Volume	23
Issue number	9
Pages (from-to)	e416-e426
Number of pages	11
ISSN	1470-2045
DOIs	https://doi.org/10.1016/S1470-2045(22)00371-0
Publication status	Published - Sep 2022

Bibliographical note

Keywords

Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Central Nervous System Neoplasms/drug therapy
Humans
Lymphoma, Large B-Cell, Diffuse/drug therapy
Methotrexate/therapeutic use
Neoplasm Recurrence, Local/pathology

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10.1016/S1470-2045(22)00371-0

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title = "CNS prophylaxis for diffuse large B-cell lymphoma",

abstract = "CNS relapse in the brain parenchyma, eyes, or leptomeninges is an uncommon but devastating complication of diffuse large B-cell lymphoma. CNS prophylaxis strategies, typically involving intrathecal or high-dose antimetabolites, have been developed in the front-line treatment setting with the aim to reduce this subsequent risk. Clinical and biological features associated with elevated risk are increasingly well defined and are discussed in this Review. This Review summarises both the historical and current developments in this challenging field, provides a nuanced discussion regarding current reasons for and against standard prophylactic measures, outlines evidence for the timing of prophylactic measures when delivered, and reflects on possible future developments.",

keywords = "Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Central Nervous System Neoplasms/drug therapy, Humans, Lymphoma, Large B-Cell, Diffuse/drug therapy, Methotrexate/therapeutic use, Neoplasm Recurrence, Local/pathology",

author = "Eyre, {Toby A} and Savage, {Kerry J} and Cheah, {Chan Y} and El-Galaly, {Tarec C} and Lewis, {Katharine L} and Pamela McKay and Wilson, {Matthew R} and Evens, {Andrew M} and Sabela Bobillo and Diego Villa and Maurer, {Matthew J} and Kate Cwynarski and Ferreri, {Andr{\'e}s J M}",

year = "2022",

month = sep,

doi = "10.1016/S1470-2045(22)00371-0",

language = "English",

volume = "23",

pages = "e416--e426",

journal = "Lancet Oncology",

issn = "1470-2045",

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TY - JOUR

T1 - CNS prophylaxis for diffuse large B-cell lymphoma

AU - Eyre, Toby A

AU - Savage, Kerry J

AU - Cheah, Chan Y

AU - El-Galaly, Tarec C

AU - Lewis, Katharine L

AU - McKay, Pamela

AU - Wilson, Matthew R

AU - Evens, Andrew M

AU - Bobillo, Sabela

AU - Villa, Diego

AU - Maurer, Matthew J

AU - Cwynarski, Kate

AU - Ferreri, Andrés J M

PY - 2022/9

Y1 - 2022/9

N2 - CNS relapse in the brain parenchyma, eyes, or leptomeninges is an uncommon but devastating complication of diffuse large B-cell lymphoma. CNS prophylaxis strategies, typically involving intrathecal or high-dose antimetabolites, have been developed in the front-line treatment setting with the aim to reduce this subsequent risk. Clinical and biological features associated with elevated risk are increasingly well defined and are discussed in this Review. This Review summarises both the historical and current developments in this challenging field, provides a nuanced discussion regarding current reasons for and against standard prophylactic measures, outlines evidence for the timing of prophylactic measures when delivered, and reflects on possible future developments.

AB - CNS relapse in the brain parenchyma, eyes, or leptomeninges is an uncommon but devastating complication of diffuse large B-cell lymphoma. CNS prophylaxis strategies, typically involving intrathecal or high-dose antimetabolites, have been developed in the front-line treatment setting with the aim to reduce this subsequent risk. Clinical and biological features associated with elevated risk are increasingly well defined and are discussed in this Review. This Review summarises both the historical and current developments in this challenging field, provides a nuanced discussion regarding current reasons for and against standard prophylactic measures, outlines evidence for the timing of prophylactic measures when delivered, and reflects on possible future developments.

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Central Nervous System Neoplasms/drug therapy

KW - Humans

KW - Lymphoma, Large B-Cell, Diffuse/drug therapy

KW - Methotrexate/therapeutic use

KW - Neoplasm Recurrence, Local/pathology

UR - http://www.scopus.com/inward/record.url?scp=85137120902&partnerID=8YFLogxK

U2 - 10.1016/S1470-2045(22)00371-0

DO - 10.1016/S1470-2045(22)00371-0

M3 - Review article

C2 - 36055310

AN - SCOPUS:85137120902

VL - 23

SP - e416-e426

JO - Lancet Oncology

JF - Lancet Oncology

SN - 1470-2045

IS - 9

ER -

CNS prophylaxis for diffuse large B-cell lymphoma

Abstract

Bibliographical note

Keywords

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