Ineffectiveness of high?dose methotrexate for prevention of <scp>CNS</scp> relapse in diffuse large <scp>B</scp> ?cell lymphoma

Central nervous system (CNS) relapse affects 5% of diffuse large B-cell lymphoma (DLBCL) patients and portends a poor prognosis. Prophylactic intravenous high-dose methotrexate (HD-MTX) is frequently employed to reduce this risk, but there limited evidence supporting practice. We conducted multicenter retrospective study determine the CNS risk with HD-MTX in DLBCL aged 18–70 years treated Alberta, Canada between 2012 2019. Provincial guidelines recommended for at high-risk based upon CNS-IPI score, double-hit lymphoma, or testicular involvement. Among 906 median follow-up 35.3 months (range 0.29–105.7), occurred 1.9% 0–1, 4.9% 2–3, 12.2% 4–6 (p < .001). was administered 115/326 (35.3%) patients, whom 96 (83.5%) had score 4–6, 45 (39.1%) four (3.5%) lymphoma. The number doses two 1–3). similar versus without (11.2% vs. 12.2%, p = .82) comparable previous reports who did not receive prophylaxis (10–12%). In multivariate propensity analyses, demonstrated no association relapse, progression-free survival, overall survival. This demonstrate benefit prophylactic patient population. Further required optimal strategy prevent DLBCL.