New risk factors and new tendency for central nervous system relapse in patients with diffuse large B-cell lymphoma:a retrospective study

作     者：Qing-Qing Cai Li-Yang Hu Qi-Rong Geng Jie Chen Zhen-Hai Lu Hui-Lan Rao Qing Liu Wen-Qi Jiang Hui-Qiang Huang Tong-Yu Lin Zhong-Jun Xia 

作者机构：State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuang-zhou 510060GuangdongP.R.China. Department of Medical OncologySun Yat-sen University Cancer Center651 Dongfeng Road EastGuang-zhou 510060GuangdongP.R.China. Department of Hematology OncologySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. Guangdong Province Key Laboratory of Arrhythmia and Elec-trophysiologyGuangzhou 510120GuangdongP.R.China. Department of RadiotherapySun Yat-sen Memorial Hospital of Sun Yat-sen UniversityGuangzhou 510120GuangdongP.R.China. Department of Colorectal Carci-nomaSun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. Department of PathologySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. Department of Cancer Preven-tion ResearchSun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. 

出 版 物：《Chinese Journal of Cancer》 (Chinese Journal of Cancer)

年 卷 期：2016年第35卷第12期

页      面：713-724页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the National Natural Science Foundation of China(81372883,81001052) Natural Science Foundation of Guangdong Province,China(2015A030313020 and 8151008901000043) Science and Technology Planning Project of Guangdong Province,China(2011B031800222) Young Talents Key Project of Sun Yat?sen University(2015ykzd13,to Qing-qing Cai) Young Talents Project of Sun Yat-sen University(11ykpy56,to Qing-qing Cai) the Sister Institution Network Fund of MD Anderson Cancer Center(to Qing-qing Cai and Hui-Rao) 

主　　题：Diffuse large B?cell lymphoma Central nervous system relapse Risk factor Rituximab Intrathecal chemotherapy prophylaxis 

摘      要：Background: In patients with difuse large B?cell lymphoma(DLBCL), central nervous system(CNS) relapse is uncom?mon but is nearly always fatal. This study aimed to determine the risk factors for CNS relapse in DLBCL patients and to evaluate the eicacy of rituximab and intrathecal chemotherapy prophylaxis for CNS relapse ***: A total of 511 patients with newly diagnosed DLBCL treated at the Sun Yat?sen University Cancer Center between January 2003 and December 2012 were included in the study. Among these patients, 376 received R?CHOP regimen(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) as primary treatment, and 135 received CHOP regimen(cyclophosphamide, doxorubicin, vincristine, and prednisone) as primary treatment. Intrathe?cal chemotherapy prophylaxis(methotrexate plus cytarabine) was administered to those who were deemed at high risk for CNS relapse. In the entire cohort and in the R?CHOP set in particular, the Kaplan–Meier method coupled with the log?rank test was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis. Diferences were evaluated using a two?tailed test, and P 110 U/L(HR = 3.59, 95% CI 1.25–10.34), serum albumin(ALB) 35 g/L(HR = 3.63, 95% CI 1.25–10.51), treatment with rituxi?mab(HR = 0.34, 95% CI 0.12–0.96), and a time to complete remission ≤ 108 days(HR = 0.22, 95% CI 0.06–0.78) were independent p