Central nervous system relapse in diffuse large B lymphoma: a retrospective cohort study

Area of Science:

• Oncology
• Hematology
• Clinical Epidemiology

Background:

• Central nervous system (CNS) relapse in diffuse large B-cell lymphoma (DLBCL) significantly worsens patient prognosis.
• Existing literature shows variable incidence rates of CNS relapse, with a notable lack of data from Latin America.

Purpose of the Study:

• To determine the incidence of CNS relapse in a Latin American cohort of DLBCL patients.
• To analyze the time to CNS relapse.
• To investigate the impact of potential risk factors on CNS relapse.

Main Methods:

• A retrospective cohort study was conducted from January 2012 to June 2017.
• One hundred forty-seven DLBCL patients were analyzed.
• Data collected included patient demographics, International Prognostic Index (IPI), CNS International Prognostic Index (CNS IPI), and intrathecal prophylaxis use.

Main Results:

• The overall incidence of CNS relapse was 4.59% (8 out of 147 patients).
• The median time to CNS relapse was 6.5 months, with 87.5% of relapses occurring within the first year post-diagnosis.
• No significant risk factors for CNS involvement were identified in the bivariate analysis. The incidence at 6, 12, and 24 months was 2.7%, 4.8%, and 5.4%, respectively.

Conclusions:

• The incidence of CNS relapse in this Latin American DLBCL cohort is comparable to international findings.
• The study reinforces that most CNS relapses occur within the first year of diagnosis.
• Further collaborative research is recommended to better elucidate risk factors for CNS relapse in DLBCL.