Abstract

Central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) is a devastating event occurring in ~ 5% of patients treated with R-CHOP. We hypothesized that adding lenalidomide to R-CHOP (R2CHOP) may decrease the risk of CNS relapse. We analyzed records for patients with DLBCL from two R2CHOP trials. We assessed variables pertinent to the CNS-International Prognostic Index (CNS-IPI) scoring system and classified patients into groups of low, intermediate, and high risk of CNS relapse. The 2-year CNS relapse rate for each risk group was estimated using the Kaplan–Meier method and compared with reported rates in cohorts treated with contemporary chemoimmunotherapy. A total of 136 patients were included. Mean age was 65 and median follow-up was 48.2 months. 10.3, 71.3, and 18.4% of patients were classified into low, intermediate, and high-risk CNS-IPI groups, respectively. Only one of 136 patients developed CNS relapse, corresponding to an incidence of 0.7% and an estimated 2-year CNS relapse rate of 0.9% for the entire R2CHOP cohort. The estimated 2-year CNS relapse rates for the low, intermediate, and high-risk groups were 0, 0, and 5.0%, respectively. Frontline therapy with R2CHOP in patients with DLBCL is associated with a lower-than-expected rate of CNS relapse.

Details

Title
CNS relapse in patients with DLBCL treated with lenalidomide plus R-CHOP (R2CHOP): analysis from two phase 2 studies
Author
Ayed, Ayed O 1   VIAFID ORCID Logo  ; Chiappella, Annalisa 2 ; Pederson, Levi 3   VIAFID ORCID Logo  ; Laplant, Betsy R 3 ; Congiu, Angela Giovanna 4 ; Gaidano, Gianluca 5 ; Spina, Michele 6 ; Re, Alessandro 7 ; Cavallo, Federica 8 ; Musuraca, Gerardo 9 ; Macon, William R 10 ; Witzig, Thomas 1 ; Vitolo, Umberto 2 ; Nowakowski, Grzegorz S 1 

1  Division of Hematology, Mayo Clinic, Rochester, MN, USA 
2  Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy 
3  Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA 
4  Department of Hematology, IRCCS San Martino Hospital and University, Genova, Italy 
5  Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy 
6  Division of Medical Oncology A, National Cancer Institute, Aviano, Italy 
7  Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy 
8  Department of Hematology, University of Torino, Torino, Italy 
9  Department of Hematology, Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori, Meldola, Italy 
10  Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA 
Pages
1-5
Publication year
2018
Publication date
Jun 2018
Publisher
Springer Nature B.V.
e-ISSN
20445385
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41408-018-0097-0
ProQuest document ID
2059533531
Copyright
© 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.