Three-Hour Infusion of Methotrexate at 3 g/m2 With or Without Intrathecal Chemotherapy Significantly Reduces CNS Relapses and Improves Survival in Patients With Large B-Cell Lymphomas at Increased CNS
6 hours ago
- #high-dose methotrexate
- #CNS prophylaxis
- #large B-cell lymphoma
- Three-hour infusion of methotrexate (HD-MTX) at 3 g/m² significantly reduces CNS relapses in high-risk large B-cell lymphoma (LBCL) patients.
- HD-MTX was well-tolerated, with 96% of patients completing therapy and no CNS relapses observed in treated high-risk patients.
- High-risk criteria included CNS-IPI ≥ 4, ≥ 3 extranodal sites, or involvement of specific organs (testis, kidney, adrenal gland, uterus, or breast).
- HD-MTX was independently associated with improved progression-free survival (PFS) and overall survival (OS) in high-risk patients.
- The study highlights the importance of a pharmacokinetic-informed dosing schedule for HD-MTX in CNS prophylaxis for LBCL patients.