Clinical Outcomes of Breast-Involved Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Real-World Study with Insights into CNS Prophylaxis.
Simple Summary: Breast-involved diffuse large B-cell lymphoma (DLBCL) is a rare form of lymphoma, and there is limited real-world evidence to guide treatment, particularly regarding the risk of spread to the central nervous system (CNS). In this study, we analyzed 33 patients treated with standard R...
| Publicado en: | Current Oncology Vol. 33; no. 8; pp. 493 - 507 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
MDPI
Aug2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196621320&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196621320 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11980052 5EKK jtl: Current Oncology issn: 11980052 maglogo: N pubinfo: dt: Aug2026 vid: 33 iid: 8 pid: 97109 pub: MDPI artinfo: ui: 196621320 10.3390/curroncol33080493 196621320 ppf: 493 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Clinical Outcomes of Breast-Involved Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Real-World Study with Insights into CNS Prophylaxis. aug: au: Nguyen, Thi Thu Huong Le, Thi Yen Nguyen, Thanh Tung Nguyen, Thanh Long Nguyen, Xuan Dai Pham, Tuan Anh Do, Anh Tu Lai, Thi Thanh Ha Le, Van Quang affil: Department of Oncology, Hanoi Medical University, Hanoi 100000, Vietnam sug: ab: Simple Summary: Breast-involved diffuse large B-cell lymphoma (DLBCL) is a rare form of lymphoma, and there is limited real-world evidence to guide treatment, particularly regarding the risk of spread to the central nervous system (CNS). In this study, we analyzed 33 patients treated with standard R-CHOP therapy at a single center. We observed high response rates and favorable long-term survival outcomes. However, CNS relapse occurred frequently in patients who did not receive preventive treatment, while no CNS relapses were seen in those who received high-dose methotrexate (HD-MTX) as prophylaxis. These findings suggest a potential benefit of CNS prophylaxis in this high-risk population. Larger studies are needed to confirm these results and help guide treatment decisions. This study evaluated clinical characteristics, treatment outcomes, and CNS relapse patterns in patients with breast-involved diffuse large B-cell lymphoma (DLBCL), a rare extranodal presentation with limited real-world data. We conducted a retrospective study on 33 consecutive patients with newly diagnosed breast-involved DLBCL treated from 2019 to 2024. All patients received R-CHOP. Baseline CNS screening—including neurological examination, fundoscopy, brain magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis—was routinely performed. High-dose methotrexate (HD-MTX) was offered as CNS prophylaxis after completion of systemic therapy based on multidisciplinary team evaluation and clinician–patient shared decision-making according to institutional treatment protocols. Median age was 52.6 years; 84.8% had ECOG 0. Non-GCB subtype predominated (84.8%), and Ki-67 >70% was present in 69.7%. The overall response rate was 90.9%, with 84.8% complete responses. At a median follow-up of 44 months, 5-year Overall Survival (OS) and Progression-Free Survival (PFS) were 84.8% and 66.7%. CNS relapse occurred in 4 of 6 patients (66.7%) without prophylaxis, all within 5–11 months after R-CHOP, whereas no CNS relapses were observed among prophylaxis recipients (p < 0.001), although this observation should be interpreted with extreme caution given the very small non-prophylaxis subgroup (n = 6), limited statistical power, and non-randomized treatment allocation. Exploratory analyses suggested that bulky disease was associated with inferior OS. R-CHOP achieved high response rates and favorable long-term outcomes in breast-involved DLBCL. The absence of CNS relapse among HD-MTX prophylaxis recipients, contrasted with a high relapse rate in those without prophylaxis, provides only a hypothesis-generating observation that requires confirmation in larger prospective studies; this warrants further investigation of the role of systemic CNS prophylaxis. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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