Incidence of Central Nervous System Relapse in Primary Mediastinal Large B-Cell Lymphoma: Implications for Central Nervous System Prophylaxis.

Autor: Okcu I; Division of Hematology, Mayo Clinic, Rochester, MN., Wang Y; Division of Hematology, Mayo Clinic, Rochester, MN., Bock AM; Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah., Zhou J; Department of Hematology, Shenzhen People's Hospital, Shenzhen, China., Moustafa MA; Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL., Tun HW; Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL., Rosenthal AC; Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ., Johnston PB; Division of Hematology, Mayo Clinic, Rochester, MN., Baidoun F; Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL., Khurana A; Division of Hematology, Mayo Clinic, Rochester, MN., Kabat BF; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN., King RL; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN., Habermann TM; Division of Hematology, Mayo Clinic, Rochester, MN., Nowakowski GS; Division of Hematology, Mayo Clinic, Rochester, MN. Electronic address: Nowakowski.grzegorz@mayo.edu.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2024 Aug 02. Date of Electronic Publication: 2024 Aug 02.
DOI: 10.1016/j.clml.2024.07.019
Abstrakt: Background: Primary mediastinal large B-cell lymphoma (PMBCL) is an uncommon type of aggressive B-cell non-Hodgkin lymphoma. PMBCL shares some clinical and biologic features with nodular sclerosis classic Hodgkin lymphoma (cHL). Central nervous system (CNS) relapse is exceedingly rare in cHL. Therefore, it may be expected that CNS relapse in PMBCL is also uncommon. Herein, we examined the incidence of CNS relapse in patients with PMBCL treated with standard chemoimmunotherapy.
Patients and Methods: This retrospective single center analysis included 154 patients with newly diagnosed PMBCL seen at Mayo Clinic. The CNS relapse rate was calculated using a competing risk model, with death considered as a competing risk.
Results: With a median follow-up of 39 months, 3 patients experienced CNS relapse, all associated with systemic relapse. The cumulative incidence of CNS relapse for the entire cohort was 1.43% (95% CI, 0.3%-4.6%) at 1 year and 2.21% (95% CI, 0.6%-5.8%) at both 2 and 5 years. For those who did not receive CNS prophylaxis (n = 131), the incidence was 0.85% (95% CI, 0.1%-4.2%) at 1 year and 1.80% (95% CI, 0.3%-5.8%) at both 2 and 5 years. All 3 patients who experienced CNS relapse had R-CHOP as frontline therapy; 2 patients did not receive any CNS prophylaxis, while 1 patient received intrathecal CNS prophylaxis.
Conclusion: The risk of CNS relapse in PMBCL appears to be very low after treatment with standard chemoimmunotherapy, suggesting routine CNS prophylaxis is not necessary.
Competing Interests: Disclosure Y.W.: Research funding (to institution): Incyte, InnoCare, LOXO Oncology, Eli Lilly, MorphoSys, Novartis, Genentech, Genmab, AbbVie, BeiGene, Merck; Advisory board (compensation to institution): Eli Lilly, LOXO Oncology, TG Therapeutics, Incyte, InnoCare, Kite, Jansen, BeiGene, AstraZeneca, Genmab, AbbVie; Consultancy (compensation to institution): InnoCare, AbbVie; Honorarium (to institution): Kite. A.M.B.: Consulting/advisory board: AbbVie. M.A.M.: Consulting or Advisory Role: Abbvie, Acrotech Biopharma (Inst), Cancer Network, CSL Behring. H.W.T.: Consultancy: Curis Pharmaceutical, Acrotecth, Gossamerbio. P.B.J.: Advisory board: Miltenyi. T.M.H.: Data Monitoring Committee: Seagen, Eli Lilly & Co; Research Support (compensation to institution): Genentech, Sorrento. G.S.N.: Consulting or Advisory Role: Bantam Pharmaceutical, Celgene (Inst), Debiopharm Group, Genentech (Inst), Karyopharm Therapeutics, Kite/Gilead, kymera, MorphoSys (Inst), Ryvu Therapeutics, Selvita, TG Therapeutics; Research Funding: Celgene (Inst), MorphoSys (Inst), NanoString Technologies (Inst). I.O., J.Z., F.B., A.C.R., B.F.K., R.L.K., and A.K. declare no conflict of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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