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Highly elevated serum lactate dehydrogenase is associated with central nervous system relapse in patients with diffuse large B-cell lymphoma: Results of a multicenter prospective cohort study

 Seok Jin Kim  ;  Jun Sik Hong  ;  Myung Hee Chang  ;  Jeong-A Kim  ;  Jae-Yong Kwak  ;  Jin Seok Kim  ;  Dok Hyun Yoon  ;  Won Sik Lee  ;  Young Rok Do  ;  Hye Jin Kang  ;  Hyeon-Seok Eom  ;  Yong Park  ;  Jong-Ho Won  ;  Yeung-Chul Mun  ;  Hyo Jung Kim  ;  Jung Hye Kwon  ;  Jee Hyun Kong  ;  Sung Yong Oh  ;  Sunah Lee  ;  Sung Hwa Bae  ;  Deok-Hwan Yang  ;  Hyun Jung Jun  ;  Yang Soo Kim  ;  Hwan Jung Yun  ;  Soon Il Lee  ;  Min Kyoung Kim  ;  Eun Kyung Park  ;  Won Seog Kim  ;  Cheolwon Suh 
 ONCOTARGET , Vol.7(44) : 72033-72043, 2016 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Central Nervous System Neoplasms/blood* ; Central Nervous System Neoplasms/drug therapy ; Central Nervous System Neoplasms/pathology ; Central Nervous System Neoplasms/secondary ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lactate Dehydrogenases/blood* ; Lymphoma, Large B-Cell, Diffuse/blood* ; Lymphoma, Large B-Cell, Diffuse/drug therapy ; Lymphoma, Large B-Cell, Diffuse/pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local/blood* ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/secondary ; Prednisone/therapeutic use ; Prospective Studies ; Risk Factors ; Rituximab/therapeutic use ; Serologic Tests/methods ; Vincristine/therapeutic use ; Young Adult
central nervous system ; diffuse large B-cell lymphoma ; lactate dehydrogenase ; prognosis
Central nervous system involvement remains a challenging issue in the treatment of patients with diffuse large B-cell lymphoma. We conducted a prospective cohort study with newly diagnosed diffuse large B-cell lymphoma patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone to identify incidence and risk factors for central nervous system involvement. Among 595 patients, 279 patients received pre-treatment central nervous system evaluation, and 14 patients had central nervous system involvement at diagnosis (2.3% out of entire patients and 5.0% out of the 279 patients). For those patients, median follow-up duration was 38.2 months and some of them achieved long-term survival. Out of 581 patients who did not have central nervous system involvement at diagnosis, 26 patients underwent secondary central nervous system relapse with a median follow-up of 35 months, and the median time to central nervous system involvement was 10.4 months (range: 3.4-29.2). Serum lactate dehydrogenase > ×3 upper limit of normal range, the Eastern Cooperative Oncology Group performance status ≥ 2, and involvement of sinonasal tract or testis, were independent risk factors for central nervous system relapse in multivariate analysis. Our study suggests that enhanced stratification of serum lactate dehydrogenase according to the National Comprehensive Cancer Network-International Prognostic Index may contribute to better prediction for central nervous system relapse in patients with diffuse large B-cell lymphoma. This trial was registered at clinicaltrials.gov identifier: 01202448.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
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