Central nervous system prophylaxis in large B-cell lymphoma: A British Society for Haematology Good Practice Paper

Matthew R Wilson; Kate Cwynarski; Toby A Eyre; Jeffery Smith; Sridhar Chaganti; Christopher P Fox; Pamela McKay

doi:10.1111/bjh.19686

Central nervous system prophylaxis in large B-cell lymphoma: A British Society for Haematology Good Practice Paper

Br J Haematol. 2024 Dec;205(6):2198-2205. doi: 10.1111/bjh.19686. Epub 2024 Aug 11.

Authors

Matthew R Wilson¹, Kate Cwynarski², Toby A Eyre³, Jeffery Smith⁴, Sridhar Chaganti⁵, Christopher P Fox⁶, Pamela McKay¹

Affiliations

¹ Beatson West of Scotland Cancer Centre, Glasgow, UK.
² University College Hospital, London, UK.
³ Oxford University Hospitals NHS Trust, Churchill Cancer Centre, Oxford, UK.
⁴ Clatterbridge Cancer Centre, Liverpool, UK.
⁵ Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK.
⁶ School of Medicine, University of Nottingham, Nottingham, UK.

PMID: 39128894
DOI: 10.1111/bjh.19686

Abstract

This Good Practice Paper provides recommendations for the baseline investigation, risk stratification and use of prophylactic interventions for patients with large B-cell lymphoma at risk of central nervous system relapse. Recent evidence which has questioned the role of high-dose methotrexate in this clinical scenario is discussed in detail.

Keywords: CNS prophylaxis; CNS relapse; diffuse large B‐cell lymphoma; high‐dose methotrexate.

Publication types

Practice Guideline
Review

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Central Nervous System Neoplasms* / prevention & control
Humans
Lymphoma, Large B-Cell, Diffuse* / drug therapy
Methotrexate* / administration & dosage
Methotrexate* / therapeutic use

Substances

Methotrexate