Abstract
Central nervous system (CNS) involvement is a serious complication in patients with diffuse large B-cell lymphoma (DLBCL) and evaluating CNS risk is an important issue. Using the standard international prognostic index (IPI) and CNS-IPI, a recently proposed model including IPI risk factors and adrenal/kidney involvement, we assessed CNS risk in 1220 untreated DLBCL patients who received R-CHOP without prophylaxis. According to the standard IPI, the cumulative incidences of CNS involvement at 2 years were 1.3, 4.6, 8.8, and 12.7% in the low-, low-intermediate-, high-intermediate-, and high-risk groups, respectively (p <.001). This result is comparable with that of the CNS-IPI. Patients with breast involvement tended to have lower risk according to the standard IPI but showed frequent CNS involvement, similar to patients with testis involvement. The standard IPI is also a useful predictor of CNS involvement. Patients with breast/testis involvement would be candidates for prophylaxis regardless of the standard IPI risk.
Acknowledgments
We are grateful to Yoshio Saburi (Oita Prefectural Hospital), Haruhisa Nagoshi (St. Marianna University School of Medicine Yokohama City Seibu Hospital), Jun Ishikawa (Osaka Medical Center for Cancer and Cardiovascular Diseases), Takaaki Miyake (Shimane University Hospital), Masaaki Noda (Hiroshima City Hospital), Takashi Okamura (Kurume University Hospital), Jun Takizawa (Niigata University Medical and Dental Hospital), Shingo Yano (Jikei University Hospital), Morio Matsumoto (Nishigunma National Hospital), Masanobu Nakata (Sapporo Hokuyu Hospital), Norio Yokose (Nippon Medical School Chiba Hokusoh Hospital), Masayuki Hino (Osaka City University Hospital), Takahiko Utsumi (Shiga Medical Center for Adults), Tomufumi Yano (Okayama Rosai Hospital), Nobuhiko Uoshima (Matsushita Memorial Hospital), Haruko Tashiro (Teikyo University Hospital), Yuji Kanisawa (Oji General Hospital), Yoshinori Tanaka (Yamaguchi University Hospital), Yoshimasa Kura (Kasukabe Municipal Hospital), Michiaki Koike (Juntendo University Shizuoka Hospital), Shiro Matsuura (Shizuoka Red Cross Hospital), Gou Aoki (Keiju Medical Center), Juichi Tanabe (Fujieda Municipal General Hospital), Sadaya Matano (Tonami General Hospital), Masanori Kume (Hiraka General Hospital), Tatsuyuki Hayashi (Tokyo Metropolitan Police Hospital), Kunio Hayashi (Hirakata Kohsai Hospital), and Takamasa Hayashi (Tenri Hospital).
Potential conflict of interest
Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2017.1330541.