对于弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者来说，中枢神经系统 (CNS) 的进展或复发仍然是一种罕见但大多致命的事件。在对 19 项前瞻性德国和法国 2/3 期试验中接受治疗的 5189 名患者进行回顾性分析中，我们确定了 159 名经历 CNS 事件的患者（复发：62%，进展：38%）。据报道，脑内、脑膜、脊柱内或联合受累的患者分别为 44%、31%、3% 和 22%。 155 名可评估患者中的 62 名 (40%) 表现出并发的系统性进展/复发。 82% 的中枢神经系统事件发生在研究纳入或随机分组后两年内。 87% 的患者表现出中枢神经系统以外的结外受累。患者的预后通常较差，中位总生存期 (OS) 为 3.4 个月 (95% CI 2.9-4.2)，2 年 OS 为 15% (10-22%)。结果并不因中枢神经系统事件的部位或时间点而异。患有孤立性 CNS 事件的患者表现出显着更好的 OS (p = 0.023)。 25 名患者接受自体或同种异体干细胞移植，3 年 OS 达到 36% (20-66%)。这项包含 5000 多名 DLBCL 患者的大型研究强调了改善中枢神经系统复发 DLBCL 患者预后的未满足的医疗需求。© 2024。作者获得 Springer Nature Limited 的独家许可。

Progression or relapse in the central nervous system (CNS) remains a rare but mostly fatal event for patients with diffuse large B-cell lymphoma (DLBCL). In a retrospective analysis of 5189 patients treated within 19 prospective German and French phase 2/3 trials, we identified 159 patients experiencing a CNS event (relapse: 62%, progression: 38%). Intracerebral, meningeal, intraspinal, or combined involvement was reported in 44%, 31%, 3%, and 22% of patients, respectively. 62 of 155 evaluable patients (40%) showed concurrent systemic progression/ relapse. 82% of all CNS events occurred within two years after study inclusion or randomization. 87% of patients showed extranodal involvement outside the CNS. Patients generally had poor outcomes with a median overall survival (OS) of 3.4 months (95% CI 2.9-4.2) and a 2-year OS of 15% (10-22%). Outcomes did not differ depending on the site or time point of CNS events. Patients with isolated CNS events demonstrated significantly better OS (p = 0.023). Twenty-five patients were consolidated with autologous or allogeneic stem cell transplantation and achieved a 3-year OS of 36% (20-66%). This large study including more than 5000 DLBCL patients highlights the unmet medical need to improve the outcome of DLBCL patients suffering from CNS relapse.© 2024. The Author(s), under exclusive licence to Springer Nature Limited.