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Central nervous system chemoprophylaxis in non-Hodgkin lymphoma: current practice in the UK

Cheung, C.W., Burton, C., Smith, P., Linch, D.C., Hoskin, P.J. and Ardeshna, K.M. (2005) Central nervous system chemoprophylaxis in non-Hodgkin lymphoma: current practice in the UK. British Journal of Haematology, 131 (2). pp. 193-200. ISSN 0007-1048

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Central nervous system (CNS) involvement in non-Hodgkin lymphoma (NHL) is a well-recognised complication. There is no consensus regarding indications for prophylaxis or a standard CNS chemoprophylaxis regimen. Current UK practice was evaluated using a questionnaire. A total of 223 questionnaires were sent to clinicians who administered chemotherapy to patients with NHL; 158 (71%) evaluable questionnaires were returned. The overwhelming majority of respondents used prophylaxis in all cases of lymphoblastic lymphoma (97%) and Burkitt lymphoma (96%). Ninety-six per cent of respondents required risk factors to be present before prophylaxis was initiated in cases of diffuse large B-cell lymphoma. The commonest risk factor was site of involvement (paranasal sinus 88%, testicular 85%, orbital cavity 78%, bone marrow 65% and bone 28%). Other risk factors included stage IV, high International Prognostic Index score, >1 extranodal site and raised lactate dehydrogenase levels (34%, 21%, 16% and 10%). A total of 82% did not give prophylaxis in follicular lymphoma and 90% used intrathecal chemotherapy as their preferred method of prophylaxis. The most popular regimen was 12·5 mg methotrexate with each cycle of chemotherapy for six courses. Thirty-nine per cent used systemic chemotherapy for CNS prophylaxis either alone (4%) or as an adjunct to intrathecal prophylaxis (35%). These variations in the indications and methods of prophylaxis indicate that this subject deserves further review.

Item Type: Article
Keywords: central nervous system • prophylaxis • non-Hodgkin lymphoma • survey
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 11 Aug 2009 16:10
Last Modified: 11 Aug 2009 16:10
Published Version: http://dx.doi.org/10.1111/j.1365-2141.2005.05756.x
Status: Published
Publisher: Blackwell Publishing Ltd
Identification Number: 10.1111/j.1365-2141.2005.05756.x
URI: http://eprints.whiterose.ac.uk/id/eprint/5754

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