CONGRESS |
#EHA2026 | PRESENTATION
Matthew R. Wilson, Beatson West of Scotland Cancer Centre, Glasgow, presents findings from an international retrospective analysis evaluating HD-MTX for CNS relapse prophylaxis in patients with ultra high-risk LBCL receiving curative-intent chemoimmunotherapy (N = 1,923; HD-MTX, n = 872; no HD-MTX, n = 1,051).
HD-MTX did not significantly reduce 3-year CNS relapse vs no HD-MTX in UHR patients (6.6% vs 6.7%; adjusted HR, 0.95). Rates of isolated CNS relapse were also similar with HD-MTX vs no HD-MTX (4.8% vs 6.6%; adjusted HR, 0.81). In propensity score matching (501 pairs), 3-year CNS relapse was 7.4% vs 6.2% (HR, 0.86), and isolated CNS relapse was 5.3% vs 4.5% (HR, 0.83). No benefit was seen in any individual ultra high-risk subgroup. In the matched cohort, 3-year EFS and OS were similar with HD-MTX vs no HD-MTX (73.8% vs 73.7%; p = 0.65 and 82.6% vs 82.7%; p = 0.94).
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