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The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma: An international multicenter study of 1532 patients treated with chemoimmunotherapy

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Harvard

El-Galaly, TC, Villa, D, Michaelsen, TY, Hutchings, M, Mikhaeel, NG, Savage, KJ, Sehn, LH, Barrington, S, Hansen, JW, Smith, D, Rady, K, Mylam, KJ, Larsen, TS, Holmberg, S, Juul, MB, Cordua, S, Clausen, MR, Jensen, KB, Johnsen, HE, Seymour, JF, Connors, JM, de Nully Brown, P, Bøgsted, M & Cheah, CY 2017, 'The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma: An international multicenter study of 1532 patients treated with chemoimmunotherapy', European journal of cancer (Oxford, England : 1990), bind 75, s. 195-203. https://doi.org/10.1016/j.ejca.2016.12.029

APA

El-Galaly, T. C., Villa, D., Michaelsen, T. Y., Hutchings, M., Mikhaeel, N. G., Savage, K. J., Sehn, L. H., Barrington, S., Hansen, J. W., Smith, D., Rady, K., Mylam, K. J., Larsen, T. S., Holmberg, S., Juul, M. B., Cordua, S., Clausen, M. R., Jensen, K. B., Johnsen, H. E., ... Cheah, C. Y. (2017). The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma: An international multicenter study of 1532 patients treated with chemoimmunotherapy. European journal of cancer (Oxford, England : 1990), 75, 195-203. https://doi.org/10.1016/j.ejca.2016.12.029

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Author

El-Galaly, Tarec Christoffer ; Villa, Diego ; Michaelsen, Thomas Yssing ; Hutchings, Martin ; Mikhaeel, Nabegh George ; Savage, Kerry J ; Sehn, Laurie H ; Barrington, Sally ; Hansen, Jakob W ; Smith, Daniel ; Rady, Kirsty ; Mylam, Karen J ; Larsen, Thomas S ; Holmberg, Staffan ; Juul, Maja B ; Cordua, Sabrina ; Clausen, Michael R ; Jensen, Kristina B ; Johnsen, Hans E ; Seymour, John F ; Connors, Joseph M ; de Nully Brown, Peter ; Bøgsted, Martin ; Cheah, Chan Y. / The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma : An international multicenter study of 1532 patients treated with chemoimmunotherapy. I: European journal of cancer (Oxford, England : 1990). 2017 ; Bind 75. s. 195-203.

Bibtex

@article{e500887308b247ffb7d8c881e5f51073,
title = "The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma: An international multicenter study of 1532 patients treated with chemoimmunotherapy",
abstract = "PURPOSE: Development of secondary central nervous system involvement (SCNS) in patients with diffuse large B-cell lymphoma is associated with poor outcomes. The CNS International Prognostic Index (CNS-IPI) has been proposed for identifying patients at greatest risk, but the optimal model is unknown.METHODS: We retrospectively analysed patients with diffuse large B-cell lymphoma diagnosed between 2001 and 2013, staged with PET/CT and treated with R-CHOP(-like) regimens. Baseline clinicopathologic characteristics, treatments, and outcome data were collected from clinical databases and medical files. We evaluated the association between candidate prognostic factors and modelled different risk models for predicting SCNS.RESULTS: Of 1532 patients, 62 (4%) subsequently developed SCNS. By multivariate analysis, disease stage III/IV, elevated serum LDH, kidney/adrenal and uterine/testicular involvement were independently associated with SCNS. There was a strong correlation between absolute number of extranodal sites and risk of SCNS; the 144 patients (9%) with >2 extranodal sites had a 3-year cumulative incidence of SCNS of 15.2% (95% confidence interval [CI] 9.2-21.2%) compared with 2.6% (95% CI 1.7-3.5) among those with ≤2 sites (P < 0.001). The 3-year cumulative risks of SCNS for CNS-IPI defined risk groups were 11.2%, 3.1% and 0.4% for high-, intermediate- and low-risk patients, respectively. All risk models analysed had high negative predictive values, but only modest positive predictive values.CONCLUSIONS: Patients with >2 extranodal sites or high-risk disease according to the CNS-IPI should be considered for baseline CNS staging. Clinical risk prediction models suffer from limited positive predictive ability, highlighting the need for more sensitive biomarkers to identify patients at highest risk of this devastating complication.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Combined Chemotherapy Protocols, Central Nervous System Neoplasms, Combined Modality Therapy, Cyclophosphamide, Doxorubicin, Humans, Immunotherapy, Lymphoma, Large B-Cell, Diffuse, Male, Middle Aged, Neoplasm Recurrence, Local, Positron Emission Tomography Computed Tomography, Prednisone, Retrospective Studies, Risk Factors, Treatment Outcome, Vincristine, Young Adult, Journal Article, Multicenter Study",
author = "El-Galaly, {Tarec Christoffer} and Diego Villa and Michaelsen, {Thomas Yssing} and Martin Hutchings and Mikhaeel, {Nabegh George} and Savage, {Kerry J} and Sehn, {Laurie H} and Sally Barrington and Hansen, {Jakob W} and Daniel Smith and Kirsty Rady and Mylam, {Karen J} and Larsen, {Thomas S} and Staffan Holmberg and Juul, {Maja B} and Sabrina Cordua and Clausen, {Michael R} and Jensen, {Kristina B} and Johnsen, {Hans E} and Seymour, {John F} and Connors, {Joseph M} and {de Nully Brown}, Peter and Martin B{\o}gsted and Cheah, {Chan Y}",
note = "Copyright {\textcopyright} 2017 Elsevier Ltd. All rights reserved.",
year = "2017",
month = apr,
doi = "10.1016/j.ejca.2016.12.029",
language = "English",
volume = "75",
pages = "195--203",
journal = "European Journal of Cancer, Supplement",
issn = "0959-8049",
publisher = "Pergamon",

}

RIS

TY - JOUR

T1 - The number of extranodal sites assessed by PET/CT scan is a powerful predictor of CNS relapse for patients with diffuse large B-cell lymphoma

T2 - An international multicenter study of 1532 patients treated with chemoimmunotherapy

AU - El-Galaly, Tarec Christoffer

AU - Villa, Diego

AU - Michaelsen, Thomas Yssing

AU - Hutchings, Martin

AU - Mikhaeel, Nabegh George

AU - Savage, Kerry J

AU - Sehn, Laurie H

AU - Barrington, Sally

AU - Hansen, Jakob W

AU - Smith, Daniel

AU - Rady, Kirsty

AU - Mylam, Karen J

AU - Larsen, Thomas S

AU - Holmberg, Staffan

AU - Juul, Maja B

AU - Cordua, Sabrina

AU - Clausen, Michael R

AU - Jensen, Kristina B

AU - Johnsen, Hans E

AU - Seymour, John F

AU - Connors, Joseph M

AU - de Nully Brown, Peter

AU - Bøgsted, Martin

AU - Cheah, Chan Y

N1 - Copyright © 2017 Elsevier Ltd. All rights reserved.

PY - 2017/4

Y1 - 2017/4

N2 - PURPOSE: Development of secondary central nervous system involvement (SCNS) in patients with diffuse large B-cell lymphoma is associated with poor outcomes. The CNS International Prognostic Index (CNS-IPI) has been proposed for identifying patients at greatest risk, but the optimal model is unknown.METHODS: We retrospectively analysed patients with diffuse large B-cell lymphoma diagnosed between 2001 and 2013, staged with PET/CT and treated with R-CHOP(-like) regimens. Baseline clinicopathologic characteristics, treatments, and outcome data were collected from clinical databases and medical files. We evaluated the association between candidate prognostic factors and modelled different risk models for predicting SCNS.RESULTS: Of 1532 patients, 62 (4%) subsequently developed SCNS. By multivariate analysis, disease stage III/IV, elevated serum LDH, kidney/adrenal and uterine/testicular involvement were independently associated with SCNS. There was a strong correlation between absolute number of extranodal sites and risk of SCNS; the 144 patients (9%) with >2 extranodal sites had a 3-year cumulative incidence of SCNS of 15.2% (95% confidence interval [CI] 9.2-21.2%) compared with 2.6% (95% CI 1.7-3.5) among those with ≤2 sites (P < 0.001). The 3-year cumulative risks of SCNS for CNS-IPI defined risk groups were 11.2%, 3.1% and 0.4% for high-, intermediate- and low-risk patients, respectively. All risk models analysed had high negative predictive values, but only modest positive predictive values.CONCLUSIONS: Patients with >2 extranodal sites or high-risk disease according to the CNS-IPI should be considered for baseline CNS staging. Clinical risk prediction models suffer from limited positive predictive ability, highlighting the need for more sensitive biomarkers to identify patients at highest risk of this devastating complication.

AB - PURPOSE: Development of secondary central nervous system involvement (SCNS) in patients with diffuse large B-cell lymphoma is associated with poor outcomes. The CNS International Prognostic Index (CNS-IPI) has been proposed for identifying patients at greatest risk, but the optimal model is unknown.METHODS: We retrospectively analysed patients with diffuse large B-cell lymphoma diagnosed between 2001 and 2013, staged with PET/CT and treated with R-CHOP(-like) regimens. Baseline clinicopathologic characteristics, treatments, and outcome data were collected from clinical databases and medical files. We evaluated the association between candidate prognostic factors and modelled different risk models for predicting SCNS.RESULTS: Of 1532 patients, 62 (4%) subsequently developed SCNS. By multivariate analysis, disease stage III/IV, elevated serum LDH, kidney/adrenal and uterine/testicular involvement were independently associated with SCNS. There was a strong correlation between absolute number of extranodal sites and risk of SCNS; the 144 patients (9%) with >2 extranodal sites had a 3-year cumulative incidence of SCNS of 15.2% (95% confidence interval [CI] 9.2-21.2%) compared with 2.6% (95% CI 1.7-3.5) among those with ≤2 sites (P < 0.001). The 3-year cumulative risks of SCNS for CNS-IPI defined risk groups were 11.2%, 3.1% and 0.4% for high-, intermediate- and low-risk patients, respectively. All risk models analysed had high negative predictive values, but only modest positive predictive values.CONCLUSIONS: Patients with >2 extranodal sites or high-risk disease according to the CNS-IPI should be considered for baseline CNS staging. Clinical risk prediction models suffer from limited positive predictive ability, highlighting the need for more sensitive biomarkers to identify patients at highest risk of this devastating complication.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Antibodies, Monoclonal, Murine-Derived

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Central Nervous System Neoplasms

KW - Combined Modality Therapy

KW - Cyclophosphamide

KW - Doxorubicin

KW - Humans

KW - Immunotherapy

KW - Lymphoma, Large B-Cell, Diffuse

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Positron Emission Tomography Computed Tomography

KW - Prednisone

KW - Retrospective Studies

KW - Risk Factors

KW - Treatment Outcome

KW - Vincristine

KW - Young Adult

KW - Journal Article

KW - Multicenter Study

U2 - 10.1016/j.ejca.2016.12.029

DO - 10.1016/j.ejca.2016.12.029

M3 - Journal article

C2 - 28237865

VL - 75

SP - 195

EP - 203

JO - European Journal of Cancer, Supplement

JF - European Journal of Cancer, Supplement

SN - 0959-8049

ER -

ID: 52221700