%0 Journal Article %1 Schmitz.2012 %A Schmitz, Norbert %A Zeynalova, Samira %A Glass, B. %A Kaiser, U. %A Cavallin-Stahl, E. %A Wolf, M. %A Haenel, M. %A Loeffler, Markus %A Truemper, L. %A Pfreundschuh, Michael %D 2012 %J Annals of oncology : official journal of the European Society for Medical Oncology / ESMO %K IMISE-Publikationen %N 5 %P 1267–1273 %T CNS disease in younger patients with aggressive B-cell lymphoma: an analysis of patients treated on the Mabthera International Trial and trials of the German High-Grade Non-Hodgkin Lymphoma Study Group %V 23 %X BACKGROUND\r\nTo describe incidence, risk factors, and influence of treatment on occurrence of central nervous system (CNS) relapse or progression in younger patients with aggressive B-cell lymphoma.\r\nPATIENTS AND METHODS\r\nWe analyzed 2210 patients with aggressive B-cell lymphoma treated on various studies for CNS relapse/progression. Treatment consisted of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) ± etoposide. Six hundred and twenty patients also received rituximab. CNS prophylaxis was intrathecal methotrexate on High-CHOEP and MegaCHOEP phase III studies if upper neck, head, bone marrow, or testes were involved.\r\nRESULTS\r\nFifty-six of 2196 patients (2.6\%) developed CNS disease. It occurred early (median 7.0 months), median survival was 5.0 months. Patients with age-adjusted International Prognostic Index (aaIPI) 0 or 1 treated with rituximab showed a low risk for CNS disease (2-year rates: 0\% or 0.5\%), and rituximab decreased the risk (relative risk 0.3, 95\% confidence interval 0.1-0.9, P = 0.029). Patients with aaIPI 2 or 3 showed a moderate risk (4.2\%-9.7\%) and no significant reduction of CNS disease with rituximab. CNS prophylaxis was of no significant benefit.\r\nCONCLUSIONS\r\nIn younger patients with aaIPI 0 or 1, CNS relapse/progression is very rare; in patients with aaIPI 2 or 3, the risk is higher (up to 10\%) and requires new diagnostic strategies and treatment.

@article{Schmitz.2012, abstract = {BACKGROUND\r\nTo describe incidence, risk factors, and influence of treatment on occurrence of central nervous system (CNS) relapse or progression in younger patients with aggressive B-cell lymphoma.\r\nPATIENTS AND METHODS\r\nWe analyzed 2210 patients with aggressive B-cell lymphoma treated on various studies for CNS relapse/progression. Treatment consisted of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) ± etoposide. Six hundred and twenty patients also received rituximab. CNS prophylaxis was intrathecal methotrexate on High-CHOEP and MegaCHOEP phase III studies if upper neck, head, bone marrow, or testes were involved.\r\nRESULTS\r\nFifty-six of 2196 patients (2.6\%) developed CNS disease. It occurred early (median 7.0 months), median survival was 5.0 months. Patients with age-adjusted International Prognostic Index (aaIPI) 0 or 1 treated with rituximab showed a low risk for CNS disease (2-year rates: 0\% or 0.5\%), and rituximab decreased the risk (relative risk 0.3, 95\% confidence interval 0.1-0.9, P = 0.029). Patients with aaIPI 2 or 3 showed a moderate risk (4.2\%-9.7\%) and no significant reduction of CNS disease with rituximab. CNS prophylaxis was of no significant benefit.\r\nCONCLUSIONS\r\nIn younger patients with aaIPI 0 or 1, CNS relapse/progression is very rare; in patients with aaIPI 2 or 3, the risk is higher (up to 10\%) and requires new diagnostic strategies and treatment.}, added-at = {2014-10-13T18:25:01.000+0200}, author = {Schmitz, Norbert and Zeynalova, Samira and Glass, B. and Kaiser, U. and Cavallin-Stahl, E. and Wolf, M. and Haenel, M. and Loeffler, Markus and Truemper, L. and Pfreundschuh, Michael}, biburl = {https://www.bibsonomy.org/bibtex/2842466679d21234af79174b5a35c0e83/drtester}, interhash = {f6656bc4e5b8ec2d540883fe3ef883a3}, intrahash = {842466679d21234af79174b5a35c0e83}, journal = {Annals of oncology : official journal of the European Society for Medical Oncology / ESMO}, keywords = {IMISE-Publikationen}, number = 5, pages = {1267–1273}, timestamp = {2014-12-03T00:09:10.000+0100}, title = {CNS disease in younger patients with aggressive B-cell lymphoma: an analysis of patients treated on the Mabthera International Trial and trials of the German High-Grade Non-Hodgkin Lymphoma Study Group}, volume = 23, year = 2012 }