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 |
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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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