Treatment-related outcomes and patterns of relapse in secondary CNS involvement by large B-cell lymphoma

作者：Juan Pablo Alderuccio, Diva Baggio, Sunwoo Han, Paola Ghione, Imran Nizamuddin, Jahanzaib Khwaja, Aditi Saha, Ning Dong, Yucai Wang, Hua‐Jay J. Cherng, Seda S. Tolu, Nina D. Wagner-Johnston, Thomas Ollila, Natalie S. Grover, Jean L. Koff, Amrita Desai, Praveen Ramakrishnan Geethakumari, Tamara K. Moyo, Jose Sandoval‐Sus, NARENDRANATH EPPERLA, Danielle Wallace, Manali Kamdar, Rita Tavarozzi, A. Danilov, H. Tun, Javier Munoz, Mayur Narkhede, Joanna Rhodes, Anca Prica, Andrea Kühnl, Adrian Matthew Maraj, Jessica Okosun, Jeff Smith, Wendy Osborne, Victoria Calvert, Dima El‐Sharkawi, Ammar Hilali, Graham P. Collins, Kim Linton, Nagah Elmusharaf, Anna Santarsieri, Farheen Karim, Firas Baidoun, Sarah Monick, Iris Margalit Trutzer, Jones Can, Amy Ayers, Jacopo Calabrese De Feo, John Sharp, Nilanjan Ghosh, Rachel Treitman, Avyakta Kallam, Izel Okcu, Chathuri Abeyakoon, William D. Hann, Aisling Barrett, Vismay Deshani, Brad S. Kahl, Julio C. Chávez, Adam J. Olszewski, K. Cwynarski · 发表于：Blood · 年份：2026 · DOI：10.1182/blood.2025031455 · 被引用次数：4 · 研究领域：CNS Lymphoma Diagnosis and Treatment、Glioma Diagnosis and Treatment、Lymphoma Diagnosis and Treatment

ABSTRACT: Secondary central nervous system (CNS) large B-cell lymphoma (SCNSL) occurs in the de novo setting, as a CNS-isolated relapse, or synchronous (concomitant CNS and systemic) relapse. SCNSL is a devastating event without therapeutic consensus. Thus, we aimed to evaluate treatment outcomes in an international cohort. Progression-free survival (PFS), overall survival (OS), and cumulative incidence of relapse (CIR, estimated using competing-risk models) were reported. Prognostic factors were identified in a 6-month landmark multivariate analysis. Outcomes after thiotepa autologous stem cell transplant (ASCT) and chimeric antigen receptor (CAR) T-cell therapy (CAR-T) delivered at relapse were compared after propensity score matching (PSM). A total of 1139 patients were included in the analysis (de novo: 537; relapsed SCNSL: 602). Two-year PFS estimates were 40.4%, 43.9%, and 16.2% for de novo SCNSL, CNS-isolated relapse, and synchronous relapse, respectively. Patients with CNS-isolated relapse demonstrated low rates of systemic recurrence (24-month CIR, 6%). Thiotepa-ASCT correlated with longer survival in de novo SCNSL (PFS: hazard ratio [HR], 0.57; P = .005; and OS: HR, 0.62; P = .023) and CNS-isolated relapses (PFS: HR, 0.55; P = .002; and OS: HR, 0.39; P< .0001). ASCT (thiotepa or no thiotepa) also associated with improved survival in synchronous relapses (PFS: HR, 0.57; P = .023; and OS: HR, 0.48; P = .019). Higher survival with thiotepa-ASCT than CAR-T was observed ...