Incidence and risk factors for central nervous system occurrence in elderly patients with diffuse large-B-cell lymphoma: influence of rituximab

摘要: Background The incidence of secondary central nervous system (CNS) occurrences in diffuse large-B-cell lymphoma is not sufficiently high to warrant the use CNS prophylaxis all patients. addition rituximab increases complete response rate and prolongs event-free overall survival elderly patients with such lymphoma. Patients methods We analyzed a cohort 399 prospectively treated eight cycles CHOP or without order assess if decreases risk localization. Prophylaxis disease was part treatment protocol. Results observed 20 occurrences: 12 on therapy, four after partial remission following remission. In three patients, only site relapse. multivariate analysis, increased age-adjusted International Prognostic Index (IPI) independent predictive factor recurrence. Only are alive follow-up 24 months. Conclusions Rituximab did influence occurrence, possibly because low diffusion. Direct intrathecal administration could overcome this problem. also confirmed that occurrence related IPI as well very poor prognosis relapses occurring therapy.