Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/57837
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dc.contributor.authorKitsada Wudhikarnen_US
dc.contributor.authorUdomsak Bunworasateen_US
dc.contributor.authorJakrawadee Julamaneeen_US
dc.contributor.authorArnuparp Lekhakulaen_US
dc.contributor.authorSuporn Chuncharuneeen_US
dc.contributor.authorPimjai Niparucken_US
dc.contributor.authorSupachai Ekwattanakiten_US
dc.contributor.authorArchrob Khuhapinanten_US
dc.contributor.authorLalita Norasetthadaen_US
dc.contributor.authorWeerasak Nawarawongen_US
dc.contributor.authorNisa Makruasien_US
dc.contributor.authorNonglak Kanitsapen_US
dc.contributor.authorChittima Sirijerachaien_US
dc.contributor.authorKanchana Chansungen_US
dc.contributor.authorPeerapon Wongen_US
dc.contributor.authorTontanai Numbenjaponen_US
dc.contributor.authorKannadit Prayongratanaen_US
dc.contributor.authorTawatchai Suwanbanen_US
dc.contributor.authorSomchai Wongkhanteeen_US
dc.contributor.authorPannee Praditsuktavornen_US
dc.contributor.authorTanin Intragumtornchaien_US
dc.date.accessioned2018-09-05T03:50:43Z-
dc.date.available2018-09-05T03:50:43Z-
dc.date.issued2017-01-01en_US
dc.identifier.issn14320584en_US
dc.identifier.issn09395555en_US
dc.identifier.other2-s2.0-84991660172en_US
dc.identifier.other10.1007/s00277-016-2848-yen_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84991660172&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/57837-
dc.description.abstract© 2016, Springer-Verlag Berlin Heidelberg. Secondary central nervous system (CNS) relapse is a serious and fatal complication of diffuse large B cell lymphoma (DLBCL). Data on secondary CNS (SCNS) relapse were mostly obtained from western countries with limited data from developing countries. We analyzed the data of 2034 newly diagnosed DLBCL patients enrolled into the multi-center registry under Thai Lymphoma Study Group from setting. The incidence, September 2006 to December 2013 to represent outcome from a resource limited pattern, management, and outcome of SCNS relapse were described. The 2-year cumulative incidence (CI) of SCNS relapse was 2.7 %. A total of 729, 1024, and 281 patients were classified as low-, intermediate-, and high-risk CNS international prognostic index (CNS-IPI) with corresponding 2-year CI of SCNS relapse of 1.5, 3.1, and 4.6 %, respectively (p < 0.001). Univariate analysis demonstrated advance stage disease, poor performance status, elevated lactate dehydrogenase, presence of B symptoms, more than one extranodal organ involvement, high IPI, and high CNS-IPI group as predictive factors for SCNS relapse. Rituximab exposure and intrathecal chemoprophylaxis offered no protective effect against SCNS relapse. At the time of analysis, six patients were alive. Median OS in SCNS relapsed patients was significantly shorter than relapsed patients without CNS involvement (13.2 vs 22.6 months) (p < 0.001). Primary causes of death were progressive disease (n = 35, 63.6 %) and infection (n = 9, 16.7 %). In conclusion, although the incidence of SCNS relapse in our cohort was low, the prognosis was dismal. Prophylaxis for SCNS involvement was underused even in high-risk patients. Novel approaches for SCNS relapse prophylaxis and managements are warranted.en_US
dc.subjectMedicineen_US
dc.titleSecondary central nervous system relapse in diffuse large B cell lymphoma in a resource limited country: result from the Thailand nationwide multi-institutional registryen_US
dc.typeJournalen_US
article.title.sourcetitleAnnals of Hematologyen_US
article.volume96en_US
article.stream.affiliationsChulalongkorn Universityen_US
article.stream.affiliationsPrince of Songkla Universityen_US
article.stream.affiliationsMahidol Universityen_US
article.stream.affiliationsChiang Mai Universityen_US
article.stream.affiliationsSrinakharinwirot Universityen_US
article.stream.affiliationsThammasat Universityen_US
article.stream.affiliationsKhon Kaen Universityen_US
article.stream.affiliationsNaresuan Universityen_US
article.stream.affiliationsPhramongkutklao College of Medicineen_US
article.stream.affiliationsRajavithi Hospitalen_US
article.stream.affiliationsKhonkaen Regional Hospitalen_US
article.stream.affiliationsChulabhorn Hospitalen_US
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