CHemoImmunotherapy With Early Central Nervous System (CNS) Prophylaxis
Status:
Completed
Trial end date:
2019-12-31
Target enrollment:
Participant gender:
Summary
The purpose is to test whether early central nervous system (CNS) prophylaxis given at the
beginning of therapy for young high risk diffuse large B-cell lymphoma (DLBCL) patients is
feasible and could reduce the risk of CNS relapses. Early CNS prophylaxis with two courses
high dose methotrexate (HD-MTX) in combination with
rituximab-cyclophosphamide-doxorubicin-vincristine-prednison (R-CHOP) is followed by four
courses of R-CHOP14 and etoposide (E) and one course of HD-Ara-C. In addition the patients
will receive three courses of liposomal cytarabine intrathecally. The results will be
compared to a recent Nordic CRY-04 study. Shifting of CNS prophylaxis to the beginning of the
therapy offers a potential to overcome the subclinical disease and thus reduce the risk of
early clinical CNS recurrence. As flow cytometry (FCM) can improve the sensitivity for
detecting occult leptomeningeal disease over cytology , FCM from cerebrospinal fluid will be
incorporated into the staging procedures.