Treatment Outcomes for LBCL with Central Nervous System Involvement | Juan Alderuccio, MD | #ASH24

My name is Juan Alderucho. I am from Sylvester Comprehensive Cancer Center, University of Miami in Miami, Florida. And today I will be talking about two abstracts that were presented during ASH. The first one is an international analysis in patients with secondary CNS lymphoma. Secondary CNS lymphoma by large visal lymphoma is when the lymphoma is spread to the brain. And this entity has been associated with poor outcomes. This may happen at the time of diagnosis, it's called GENOVO, or at the time of relapse that can be presented, can be located only in the central nervous system or can be synchronous what this means that it's in the central nervous system and systemically in other organs. There is no more data about prognosis factors and treatment related outcomes in this population. So we conducted an international study including several centers in the United States, Canada and the United Kingdom and we were able to extract data from more than a thousand patients. We observed that in patients with GENOVO that are those that were diagnosed at the time of diagnosis, the use of consolidation with tiotipa-based regimen has been associated to better outcomes compared to those patients that are undergoing that approach. However, if for some reason those patients cannot receive that therapy, the use of intensive regimens such as CODOX-M or IBAC or hypercebal, we compare with patients with other regimens called Mr. CHOP or EPOC without transplant, those patients selected for intensive regimen seems to be better with those approaches. Then in the relapse setting, we also evaluate patients selected for CAR T-cell or for tiotipa-based transplant and we also observe better outcomes in patients selected for a tiotipa-based transplant compared to those treated with CAR T-cell. Nevertheless, it's important to highlight that patients selected for CAR T-cell, they present the higher risk features such as double heat lymphoma, transformed lymphoma and different features at the time of diagnosis that make a higher risk population compared to patients undergoing tiotipa-based transplant.