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  • Title: Prognostic value of disease distribution in secondary central nervous system diffuse large B cell lymphoma treated with radiation therapy.
    Author: Al Feghali KA, Fang P, Gule-Monroe M, Milgrom S, Khoury JD, Gunther JR, Sheu T, Nair R, Ahmed S, Steiner R, Strati P, Shpall EJ, Nieto YL, Hosing C, Nastoupil LJ, Westin JR, Neelapu SS, Fowler N, Flowers C, Pinnix CC, Dabaja BS.
    Journal: Leuk Lymphoma; 2021 Oct; 62(10):2400-2407. PubMed ID: 33942701.
    Abstract:
    This study aimed to assess the prognostic value of baseline disease distribution for patients with the secondary central nervous system (CNS) diffuse large B-cell lymphoma (DLBCL) treated with chemotherapy and radiation (RT). 44 patients with secondary CNS DLBCL were reviewed. Twenty patients had leptomeningeal disease (LMD), and 24 had localized/targetable disease (LTD). Of 8 patients who received stem cell transplantation (SCT) after RT, 6 had LTD with a complete or partial response after RT. Median time to CNS relapse after RT was 10.1 months; 3/24 patients with LTD and 5/15 with LMD had CNS relapse. The median overall survival (OS) was 8 and 20 months for patients with LMD and LTD, respectively (p = 0.20). On multivariable analysis, LTD, receipt of SCT, and response after RT were associated with better OS and CNS-disease-free survival. Patients with localized secondary CNS DLBCL may benefit from RT serving as a bridge to SCT.
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