Incidence of central nervous system relapses in patients with DLBCL treated with lenalidomide as maintenance after R-CHOP

2] ophylaxis for CNS relapses currently employs methotrexate (MTX), a blood-brain barrier-penetrating drug, 9 although the efficacy of intrathecal (IT) MTX is debated. High-dose intravenous (HDIV) MTX seems more effective, especially in younger patients, but with significant toxicity/intolerability, notably in older patients with complex comorbidities and/or impaired renal function. 12-14 Identification of alternative agents that lower the incidence of CNS relapses is needed.