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Evaluate the efficacy of CNS prophylaxis in reducing CNS relapse and disease progression in high-risk DLBCL patients.

December 8, 2025Blood

Impact of high-dose methotrexate in both central nervous system relapse and systemic progression in high-risk DLBCL: A retrospective analysis of a brazilian cohort

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Retrospective analysis reveals high-dose methotrexate does not reduce CNS relapse but lowers disease progression in high-risk DLBCL patients.

Evaluate the efficacy of CNS prophylaxis in reducing CNS relapse and disease progression in high-risk DLBCL patients.
Retrospective analysis of patients diagnosed with aggressive B-cell lymphoma with high CNS relapse risk.
Participants received anti-CD20-based chemoimmunotherapy between 2015 and 2025 in Brazil.
Logistic regression and Kaplan-Meier methods were used to analyze CNS relapse, PFS, and OS.
10% of patients experienced CNS relapse, with 80% of those resulting in death.
There was no significant reduction in CNS relapse associated with high-dose methotrexate or intrathecal methotrexate.
High-dose methotrexate significantly reduced the risk of disease progression, with a cumulative incidence of 22% in patients who received it.

Honorato et al. (2025) studied this question.

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Retrospective analysis reveals high-dose methotrexate does not reduce CNS relapse but lowers disease progression in high-risk DLBCL patients.