Highly elevated serum lactate dehydrogenase is associated with central nervous system relapse in patients with diffuse large B-cell lymphoma: Results of a multicenter prospective cohort study

Autor: Min Kyoung Kim, Soon Il Lee, Jong Ho Won, Jun Sik Hong, Hyo Jung Kim, Eunkyung Park, Won Seog Kim, Young Rok Do, Yong Park, Jung Hye Kwon, Hwan Jung Yun, Sung Yong Oh, Cheolwon Suh, Dok Hyun Yoon, Seok Jin Kim, Jee Hyun Kong, Yang Soo Kim, Hye Jin Kang, Myung Hee Chang, Yeung-Chul Mun, Jin Seok Kim, Jeong-A Kim, Hyun Jung Jun, Sung Hwa Bae, S.M. Lee, Deok Hwan Yang, Hyeon Seok Eom, Won Sik Lee, Jae Yong Kwak
Rok vydání: 2016
Předmět:
Male
Pathology
Gastroenterology
Central Nervous System Neoplasms
0302 clinical medicine
Prednisone
Risk Factors
Antineoplastic Combined Chemotherapy Protocols
Medicine
Prospective Studies
Prospective cohort study
Aged
80 and over
Middle Aged
medicine.anatomical_structure
Oncology
Vincristine
030220 oncology & carcinogenesis
Rituximab
Female
Lymphoma
Large B-Cell
Diffuse
medicine.drug
Research Paper
Adult
medicine.medical_specialty
Cyclophosphamide
Central nervous system
diffuse large B-cell lymphoma
03 medical and health sciences
Young Adult
Internal medicine
Humans
Serologic Tests
Lactate Dehydrogenases
Aged
business.industry
lactate dehydrogenase
medicine.disease
central nervous system
Lymphoma
Doxorubicin
prognosis
Neoplasm Recurrence
Local
business
Diffuse large B-cell lymphoma
030215 immunology
Follow-Up Studies
Zdroj: Oncotarget
ISSN: 1949-2553
0120-2448
Popis: Central nervous system involvement remains a challenging issue in the treatment of patients with diffuse large B-cell lymphoma. We conducted a prospective cohort study with newly diagnosed diffuse large B-cell lymphoma patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone to identify incidence and risk factors for central nervous system involvement. Among 595 patients, 279 patients received pre-treatment central nervous system evaluation, and 14 patients had central nervous system involvement at diagnosis (2.3% out of entire patients and 5.0% out of the 279 patients). For those patients, median follow-up duration was 38.2 months and some of them achieved long-term survival. Out of 581 patients who did not have central nervous system involvement at diagnosis, 26 patients underwent secondary central nervous system relapse with a median follow-up of 35 months, and the median time to central nervous system involvement was 10.4 months (range: 3.4-29.2). Serum lactate dehydrogenase > ×3 upper limit of normal range, the Eastern Cooperative Oncology Group performance status ≥ 2, and involvement of sinonasal tract or testis, were independent risk factors for central nervous system relapse in multivariate analysis. Our study suggests that enhanced stratification of serum lactate dehydrogenase according to the National Comprehensive Cancer Network-International Prognostic Index may contribute to better prediction for central nervous system relapse in patients with diffuse large B-cell lymphoma. This trial was registered at clinicaltrials.gov identifier: 01202448.
Databáze: OpenAIRE
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