• The lancet oncology · Sep 2022

    Review

    CNS prophylaxis for diffuse large B-cell lymphoma.

    • Toby A Eyre, Kerry J Savage, Chan Y Cheah, Tarec C El-Galaly, Katharine L Lewis, Pamela McKay, Matthew R Wilson, Andrew M Evens, Sabela Bobillo, Diego Villa, Matthew J Maurer, Kate Cwynarski, and FerreriAndrés J MAJMLymphoma Unit, Department of Onco-Haematology, IRCCS San Raffaele Scientific Institute, Milan, Italy..
    • Department of Haematology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. Electronic address: toby.eyre@ouh.nhs.uk.
    • Lancet Oncol. 2022 Sep 1; 23 (9): e416e426e416-e426.

    AbstractCNS relapse in the brain parenchyma, eyes, or leptomeninges is an uncommon but devastating complication of diffuse large B-cell lymphoma. CNS prophylaxis strategies, typically involving intrathecal or high-dose antimetabolites, have been developed in the front-line treatment setting with the aim to reduce this subsequent risk. Clinical and biological features associated with elevated risk are increasingly well defined and are discussed in this Review. This Review summarises both the historical and current developments in this challenging field, provides a nuanced discussion regarding current reasons for and against standard prophylactic measures, outlines evidence for the timing of prophylactic measures when delivered, and reflects on possible future developments.Copyright © 2022 Elsevier Ltd. All rights reserved.

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