The standard international prognostic index for predicting the risk of CNS involvement in DLBCL without specific prophylaxis. Issue 1 (2nd January 2018)

• Record Type: Journal Article
• Authors: Tomita, Naoto; Yokoyama, Masahiro; Yamamoto, Wataru; Watanabe, Reina; Shimazu, Yutaka; Masaki, Yasufumi; Tsunoda, Saburo; Hashimoto, Chizuko; Murayama, Kayoko; Yano, Takahiro; Okamoto, Rumiko; Kikuchi, Ako; Tamura, Kazuo; Sato, Kazuya; Sunami, Kazutaka; Shibayama, Hirohiko; Takimoto, Rishu; Ohshima, Rika; Takahashi, Hiromichi; Moriuchi, Yukiyoshi; Kinoshita, Tomohiro; Yamamoto, Masahide; Numata, Ayumi; Nakajima, Hideaki; Miura, Ikuo; Takeuchi, Kengo
• Is Part Of: Leukemia & lymphoma. Volume 59:Issue 1(2018)
• Page Start: 97
• Page End: 104
• Publication Date: 2018-01-02
• Subjects: International prognostic index -- central nervous system -- diffuse large B-cell lymphoma -- R-CHOP -- prophylaxis; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2017.1330541
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Central nervous system (CNS) involvement is a serious complication in patients with diffuse large B-cell lymphoma (DLBCL) and evaluating CNS risk is an important issue. Using the standard international prognostic index (IPI) and CNS-IPI, a recently proposed model including IPI risk factors and adrenal/kidney involvement, we assessed CNS risk in 1220 untreated DLBCL patients who received R-CHOP without prophylaxis. According to the standard IPI, the cumulative incidences of CNS involvement at 2 years were 1.3, 4.6, 8.8, and 12.7% in the low-, low-intermediate-, high-intermediate-, and high-risk groups, respectively ( p <.001). This result is comparable with that of the CNS-IPI. Patients with breast involvement tended to have lower risk according to the standard IPI but showed frequent CNS involvement, similar to patients with testis involvement. The standard IPI is also a useful predictor of CNS involvement. Patients with breast/testis involvement would be candidates for prophylaxis regardless of the standard IPI risk.