Treatment-related leukoencephalopathy in adults with central nervous system lymphoma: a retrospective analysis of 126 patients.

Autor: Masuda Y; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Nara K; Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan., Fujii-Mori A; Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan., Shimura A; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Taoka K; Clinical Application for Development of Therapy for Rare Disease, The University of Tokyo Hospital, Tokyo, Japan., Watadani T; Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan., Morita K; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Yamamoto T; Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan. takehitoyamamoto@g.ecc.u-tokyo.ac.jp., Kurokawa M; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan., Takada T; Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2024 Sep 13. Date of Electronic Publication: 2024 Sep 13.
DOI: 10.1007/s00277-024-05989-1
Abstrakt: Neurotoxicity associated with high-dose chemotherapy and whole brain radiotherapy (WBRT) is one of major complications for patients with central nervous system lymphoma (CNSL). Here we determined the incidence and risk factors of treatment-related leukoencephalopathy (tLE) in a clinical setting. We retrospectively reviewed clinical and radiological findings of 126 patients with  (CNSL) treated with high-dose methotrexate with or without intrathecal methotrexate administration (IT MTX) and response-adapted WBRT. During the whole observation period with a median of 38.7 months, tLE was found in 33 patients, most of them asymptomatic, with the median time to development 3.0 months, and the cumulative incidence reaching 29.2% (95% confidence interval, 20.6-38.2%) two years post chemotherapy. By multivariable analysis, IT MTX was identified as the only one significant risk factor (hazard ratio, 4.50; P < 0.001), and the number of IT MTX was associated with the increased incidence and severity of tLE. These findings highlight the frequent neurological complications associated with CNS-directed therapy and confirm the neurotoxicity of IT MTX.
(© 2024. The Author(s).)
Databáze: MEDLINE
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