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 BaeDeok 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

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6 Citations (Scopus)

Abstract

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 followup 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.

Original languageEnglish
Pages (from-to)72033-72043
Number of pages11
JournalOncotarget
Volume7
Issue number44
DOIs
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Oncology

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    Kim, S. J., Hong, J. S., Chang, M. H., Kim, J. A., Kwak, J. Y., Kim, J. S., Yoon, D. H., Lee, W. S., Do, Y. R., Kang, H. J., Eom, H. S., Park, Y., Won, J. H., Mun, Y. C., Kim, H. J., Kwon, J. H., Kong, J. H., Oh, S. Y., Lee, S., ... Suh, C. (2016). 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. Oncotarget, 7(44), 72033-72043. https://doi.org/10.18632/oncotarget.12459