Journal article
Frequency, risk factors, and outcomes of central nervous system relapse in lymphoma patients treated with dose‐adjusted EPOCH plus rituximab
American journal of hematology, Vol.92(11), pp.1156-1162
11/2017
DOI: 10.1002/ajh.24864
PMCID: PMC11339869
PMID: 28719025
Abstract
Background
Central nervous system (CNS) relapse in non‐Hodgkin lymphoma (NHL) is a rare but serious complication that carries a poor prognosis. The use of infusional etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH‐R) for frontline treatment of diffuse large B cell lymphoma (DLBCL) is increasing, though little is known about incidence of and risk factors for CNS relapse with this regimen
Patients and methods
We completed a chart review of patients with NHL who received EPOCH‐R as front line therapy. Data obtained included baseline and treatment characteristics including if patients received CNS directed therapy. We measured overall survival (OS), progression free survival (PFS), and progression to CNS involvement.
Results
We identified 223 patients who met the inclusion criteria, 72% had DLBCL. Of all the patients, 5.8% experienced CNS relapse, and 38.6% were treated with CNS prophylaxis. There was no difference in rate of CNS relapse, OS, or PFS between patients who had and had not received CNS prophylaxis. Patients whose serum lactate dehydrogenase was greater than twice the upper limit of normal at diagnosis and those with extranodal disease were significantly more likely to have CNS relapse (P = .0247 and 0.022, respectively) than their counterparts.
Conclusions
The rate of CNS relapse in this patient population approaches 6%, not significantly different from reports on those receiving R‐CHOP. The results of this study suggest that CNS prophylaxis might be more selectively used among patients treated with EPOCH‐R with certain high‐risk features.
Details
- Title: Subtitle
- Frequency, risk factors, and outcomes of central nervous system relapse in lymphoma patients treated with dose‐adjusted EPOCH plus rituximab
- Creators
- Mary‐Kate Malecek - Northwestern UniversityAdam M. Petrich - Northwestern UniversityShaina Rozell - Northwestern UniversityBenjamin Chu - Northwestern UniversitySteven Trifilio - Northwestern UniversityNatalie Galanina - University of ChicagoMatthew Maurer - Mayo ClinicUmar Farooq - University of IowaBrian K. Link - University of IowaGrzegorz S. Nowakowski - Mayo ClinicChadi Nabhan - Cardinal HealthAyed O. Ayed - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- American journal of hematology, Vol.92(11), pp.1156-1162
- DOI
- 10.1002/ajh.24864
- PMID
- 28719025
- PMCID
- PMC11339869
- ISSN
- 0361-8609
- eISSN
- 1096-8652
- Number of pages
- 7
- Language
- English
- Date published
- 11/2017
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359954402771
Metrics
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