Clinical Outcomes of Breast‑Involved Diffuse Large B‑Cell Lymphoma Treated with R‑CHOP: A Real‑World Study with Insights into CNS Prophylaxis
High‑dose methotrexate prophylaxis after R‑CHOP appears associated with a lower rate of CNS relapse in breast‑involved DLBCL.
This study evaluated clinical characteristics, treatment outcomes, and CNS relapse patterns in patients with breast‑involved diffuse large B‑cell lymphoma (DLBCL). A retrospective cohort of 33 consecutive patients who received R‑CHOP from 2019 to 2024 was examined. High‑dose methotrexate (HD‑MTX) was offered as CNS prophylaxis after R‑CHOP in selected patients. The overall response rate was 90.9% (84.8% complete responses). At a median follow‑up of 44 months, 5‑year overall survival (OS) was 84.8% and progression‑free survival (PFS) was 66.7%. CNS relapse occurred in 4 of 6 patients (66.7%) who did not receive prophylaxis, all within 5‑11 months after R‑CHOP, whereas no CNS relapses were observed among HD‑MTX prophylaxis recipients (p < 0.001). The findings suggest a potential benefit of CNS prophylaxis in this high‑risk population but require confirmation in larger prospective studies.
Breast‑involved DLBCL is rare, and CNS relapse remains a major cause of treatment failure. Identifying effective prophylaxis strategies could improve long‑term outcomes for this high‑risk group.
Bizonyítékszint: Korai humán adat. Kis vagy feltáró emberi adat.
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