The standard international prognostic index for predicting the risk of CNS involvement in DLBCL without specific prophylaxis

• Published in: Leukemia & lymphoma Vol. 59; no. 1; pp. 97 - 104
• Main Authors: Tomita, Naoto, Yokoyama, Masahiro, Yamamoto, Wataru, Watanabe, Reina, Shimazu, Yutaka, Masaki, Yasufumi, Tsunoda, Saburo, Hashimoto, Chizuko, Murayama, Kayoko, Yano, Takahiro, Okamoto, Rumiko, Kikuchi, Ako, Tamura, Kazuo, Sato, Kazuya, Sunami, Kazutaka, Shibayama, Hirohiko, Takimoto, Rishu, Ohshima, Rika, Takahashi, Hiromichi, Moriuchi, Yukiyoshi, Kinoshita, Tomohiro, Yamamoto, Masahide, Numata, Ayumi, Nakajima, Hideaki, Miura, Ikuo, Takeuchi, Kengo
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 02.01.2018
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; central nervous system; Central Nervous System Neoplasms - epidemiology; Central Nervous System Neoplasms - mortality; Central Nervous System Neoplasms - prevention & control; Central Nervous System Neoplasms - secondary; Cyclophosphamide; diffuse large B-cell lymphoma; Doxorubicin; Female; Humans; Incidence; International prognostic index; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - epidemiology; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Middle Aged; Prednisone; Prognosis; prophylaxis; R-CHOP; Risk; Vincristine; Young Adult; International prognostic index; diffuse large B-cell lymphoma; prophylaxis; R-CHOP; central nervous system
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2017.1330541

Central nervous system (CNS) involvement is a serious complication in patients with diffuse large B-cell lymphoma (DLBCL) and evaluating CNS risk is an important issue. Using the standard international prognostic index (IPI) and CNS-IPI, a recently proposed model including IPI risk factors and adrenal/kidney involvement, we assessed CNS risk in 1220 untreated DLBCL patients who received R-CHOP without prophylaxis. According to the standard IPI, the cumulative incidences of CNS involvement at 2 years were 1.3, 4.6, 8.8, and 12.7% in the low-, low-intermediate-, high-intermediate-, and high-risk groups, respectively (p <.001). This result is comparable with that of the CNS-IPI. Patients with breast involvement tended to have lower risk according to the standard IPI but showed frequent CNS involvement, similar to patients with testis involvement. The standard IPI is also a useful predictor of CNS involvement. Patients with breast/testis involvement would be candidates for prophylaxis regardless of the standard IPI risk.