CNS RELAPSE OF DIFFUSE LARGE B‐CELL LYMPHOMA AND ROLE OF UPFRONT PROPHYLAXIS: A 10‐YEAR SINGLE CENTER EXPERIENCE

Introduction: Central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) is a rare event, occurring in about 5% patients (pts) and correlating with very dismal prognosis. Much debate has surrounded the use strategies to avert CNS disease recurrence. Nowadays, prophylaxis mostly based on high-dose intravenous (iv) methotrexate (HD-MTX), but its effectiveness controversial. Our study focuses pts DLBCL order evaluate their clinical biological features, validity known prognostic scores, efficacy prophylaxis, prognosis treatment at time relapse. Methods: All diagnosed between January 2010 December 2021 AOU Città della Salute e Scienza di Torino treated curative intent were selected: 498 cases least 12 months follow-up identified. Pts primary mediastinal lymphoma, testicular or diagnosis excluded. Results: The case series included 406 pts. Mean age was 67 years, 56/400 had ECOG PS ≥ 2 (14%), 231/400 elevated LDH levels (58%), 251/404 stage IV (62%), 192/374 IPI score 3 (51%), 189/373 CNS-IPI 2–3 91/373 4–6 (24%). 95/397 received (24%): 59 by intrathecal (IT) route only (15%) (n 26 2-3; n 29 4-6), 25 iv MTX (6%) 17 HD-MTX ≥3 g/mq; 6 16 11 combined (3%) 5 2-3, 3–6). experienced relapse; 8/12 exclusively 4/12 along systemic cumulative incidence years 2.8%. In univariate analysis risk significantly influenced levels, while not shown impact However, none who subsequent disease, 2/59 exclusive IT an superimposable whole cohort (3.3%). multivariate analysis, confirmed significant correlation such recurrence (Figure 1). With mean 36 months, 3-year overall survival for SNC 30%. Encore Abstract—previously submitted EHA 2023 Keyword: aggressive non-Hodgkin No conflicts interests pertinent abstract.