Prognostic value of disease distribution in secondary central nervous system diffuse large B cell lymphoma treated with radiation therapy. Issue 10 (24th August 2021)

• Record Type: Journal Article
• Authors: Al Feghali, Karine A.; Fang, Penny; Gule-Monroe, Maria; Milgrom, Sarah; Khoury, Joseph D.; Gunther, Jillian R.; Sheu, Tommy; Nair, Ranjit; Ahmed, Sairah; Steiner, Raphael; Strati, Paolo; Shpall, Elizabeth J.; Nieto, Yago L.; Hosing, Chitra; Nastoupil, Loretta J.; Westin, Jason R.; Neelapu, Sattva S.; Fowler, Nathan; Flowers, Christopher; Pinnix, Chelsea C.; Dabaja, Bouthaina S.
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 10(2021)
• Page Start: 2400
• Page End: 2407
• Publication Date: 2021-08-24
• Subjects: Diffuse large B-cell lymphoma -- central nervous system lymphoma -- radiation therapy -- stem cell transplantation -- salvage therapy; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1919656
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: This study aimed to assess the prognostic value of baseline disease distribution for patients with the secondary central nervous system (CNS) diffuse large B-cell lymphoma (DLBCL) treated with chemotherapy and radiation (RT). 44 patients with secondary CNS DLBCL were reviewed. Twenty patients had leptomeningeal disease (LMD), and 24 had localized/targetable disease (LTD). Of 8 patients who received stem cell transplantation (SCT) after RT, 6 had LTD with a complete or partial response after RT. Median time to CNS relapse after RT was 10.1 months; 3/24 patients with LTD and 5/15 with LMD had CNS relapse. The median overall survival (OS) was 8 and 20 months for patients with LMD and LTD, respectively ( p = 0.20). On multivariable analysis, LTD, receipt of SCT, and response after RT were associated with better OS and CNS-disease-free survival. Patients with localized secondary CNS DLBCL may benefit from RT serving as a bridge to SCT.