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D. Qualls et al.
biological factors including double- or triple-hit transloca- tions and double-expresser status in concert with determi- nation of the cell of origin. Baseline CNS evaluation may include CSF studies with cytology and flow cytometry based on patient-specific risk factors, and imaging of the neuroaxis if neurological signs or symptoms are present. For those patients at high risk of CNS relapse, prophylac- tic therapy should be considered. Our preference is to employ systemic methotrexate as first-line CNS prophy- laxis if the patient is an appropriate candidate, with intrathecal methotrexate reserved for high-risk patients
who are ineligible for systemic methotrexate because of renal dysfunction or other comorbidities. Early adminis- tration of CNS prophylaxis, during the course of initial therapy, may treat occult CNS disease and prevent early treatment failure. Finally, new targeted therapies and immune-modulating agents may provide novel opportuni- ties for the treatment and prevention of CNS relapse in the future. Inclusion of patients with secondary CNS lym- phoma in clinical trials of promising agents would signifi- cantly accelerate the rate of progress in this currently unmet medical need.
References
1. Morton LM, Wang SS, Devesa SS, et al. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood. 2006;107(1):265-276.
2. SwerdlowSH,CampoE,PileriSA,etal.The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-2390.
3. Ziepert M, Hasenclever D, Kuhnt E, et al. Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lym- phoma in the rituximab era. J Clin Oncol. 2010;28(14):2373-2380.
4. Smith A, Crouch S, Howell D, et al. Impact of age and socioeconomic status on treat- ment and survival from aggressive lym- phoma: a UK population-based study of dif- fuse large B-cell lymphoma. Cancer Epidemiol. 2015;39(6):1103-1112.
5. SehnLH,BerryB,ChhanabhaiM,etal.The revised International Prognostic Index (R- IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B- cell lymphoma treated with R-CHOP. Blood. 2007;109(5):1857-1861.
6. Ghose A, Elias HK, Guha G, et al. Influence of rituximab on central nervous system relapse in diffuse large B-cell lymphoma and role of prophylaxis--a systematic review of prospective studies. Clin Lymphoma Myeloma Leuk. 2015;15(8):451-457.
7. ZhangJ,ChenB,XuX.Impactofrituximab on incidence of and risk factors for central nervous system relapse in patients with dif- fuse large B-cell lymphoma: a systematic review and meta-analysis. Leuk Lymphoma. 2014;55(3):509-514.
8. Boehme V, Zeynalova S, Kloess M, et al. Incidence and risk factors of central nervous system recurrence in aggressive lymphoma- -a survey of 1693 patients treated in proto- cols of the German High-Grade Non- Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol. 2007;18(1):149-157.
9. Bjorkholm M, Hagberg H, Holte H, et al. Central nervous system occurrence in elder- ly patients with aggressive lymphoma and a long-term follow-up. Ann Oncol. 2007;18(6):1085-1089.
10. Bernstein SH, Unger JM, Leblanc M, et al. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2009;27(1):114-119.
11. WilsonWH,BrombergJE,Stetler-Stevenson M, et al. Detection and outcome of occult leptomeningeal disease in diffuse large B-cell
lymphoma and Burkitt lymphoma.
Haematologica, 2014;99(7):1228-1235.
12. Hegde U, Filie A, Little RF, et al. High inci- dence of occult leptomeningeal disease detected by flow cytometry in newly diag- nosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology.
Blood. 2005;105(2):496-502.
13. Benevolo G, Stacchini A, Spina M, et al.
Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination. Blood. 2012;120(16):3222-3228.
14. Alvarez R, Dupuis J, Plonquet A, et al. Clinical relevance of flow cytometric immunophenotyping of the cerebrospinal fluid in patients with diffuse large B-cell lymphoma. Ann Oncol. 2012;23(5):1274- 1279.
15. Sancho JM, Orfao A, Quijano S, et al. Clinical significance of occult cerebrospinal fluid involvement assessed by flow cytome- try in non-Hodgkin's lymphoma patients at high risk of central nervous system disease in the rituximab era. Eur J Haematol. 2010;85(4):321-328.
16. Boehme V, Schmitz N, Zeynalova S, et al. CNS events in elderly patients with aggres- sive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High- Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Blood. 2009;113(17): 3896-3902.
17. El-Galaly TC, Villa D, Michaelsen TY, et al. The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma: An international multicenter study of 1532 patients treated with chemoimmunotherapy. Eur J Cancer. 2017;75:195-203.
18. Schmitz N, Zeynalova S, Nickelsen M, et al. CNS International Prognostic Index: a risk model for CNS relapse in patients with dif- fuse large B-cell lymphoma treated with R- CHOP. J Clin Oncol. 2016;34(26):3150-3156.
19. Gleeson M, Counsell N, Cunningham D, et al. Central nervous system relapse of diffuse large B-cell lymphoma in the rituximab era: results of the UK NCRI R-CHOP-14 versus 21 trial. Ann Oncol. 2017;28(10):2511-2516.
20. Guirguis HR, Cheung MC, Mahrous M, et al. Impact of central nervous system (CNS) prophylaxis on the incidence and risk factors for CNS relapse in patients with diffuse large B-cell lymphoma treated in the ritux- imab era: a single centre experience and review of the literature. Br J Haematol. 2012;159(1):39-49.
21. Mitrovic Z, Bast M, Bierman PJ, et al. The addition of rituximab reduces the incidence of secondary central nervous system involvement in patients with diffuse large B- cell lymphoma. Br J Haematol. 2012;157 (3):401-403.
22. Kumar A, Vanderplas A, LaCasce AS, et al. Lack of benefit of central nervous system prophylaxis for diffuse large B-cell lym- phoma in the rituximab era: findings from a large national database. Cancer. 2012;118 (11):2944-2951.
23. Holte H, Leppa S, Bjorkholm M, et al. Dose- densified chemoimmunotherapy followed by systemic central nervous system prophy- laxis for younger high-risk diffuse large B- cell/follicular grade 3 lymphoma patients: results of a phase II Nordic Lymphoma Group study. Ann Oncol. 2013;24(5):1385- 1392.
24. Uni M, Kagoya Y, Nannya Y, et al. Central nervous system relapse in patients with dif- fuse large B-cell lymphoma: analysis of inci- dence and prognostic factors. Leuk Lymphoma. 2015;56(6):1869-1871.
25. Blum KA, Lozanski G, Byrd JC. Adult Burkitt leukemia and lymphoma. Blood. 2004;104(10):3009-3020.
26. Cortes J, O'Brien SM, Pierce S, et al. The value of high-dose systemic chemotherapy and intrathecal therapy for central nervous system prophylaxis in different risk groups of adult acute lymphoblastic leukemia. Blood. 1995;86(6):2091-2097.
27. Haioun C, Besson C, Lepage E, et al. Incidence and risk factors of central nervous system relapse in histologically aggressive non-Hodgkin's lymphoma uniformly treat- ed and receiving intrathecal central nervous system prophylaxis: a GELA study on 974 patients. Ann Oncol. 2017;11(6):685-690.
28. Hollender A, Kvaloy S, Nome O, et al. Central nervous system involvement fol- lowing diagnosis of non-Hodgkin's lym- phoma: a risk model. Ann Oncol. 2002;13 (7):1099-1107.
29. A predictive model for aggressive non- Hodgkin's lymphoma. N Engl J Med. 1993; 329(14):987-994.
30. Tomita N, Yokoyama M, Yamamoto W, et al. The standard international prognostic index for predicting the risk of CNS involve- ment in DLBCL without specific prophylax- is. Leuk Lymphoma. 2018;59(1):97-104.
31. Kridel R, Telio D, Villa D, et al. Diffuse large B-cell lymphoma with testicular involve- ment: outcome and risk of CNS relapse in the rituximab era. Br J Haematol. 2017;176 (2):210-221.
32. Zucca E, Conconi A, Mughal TI, et al. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis
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