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CNS-Relapse Prevention in High-Risk Diffuse Large B-cell Lymphoma With Thiotepa-based Auto

A serious consequence of systemic diffuse large B-cell lymphoma (DLBCL) is secondary central nervous system (CNS) relapse, which occurs in approximately 5% of all patients. Many CNS relapses occur within the first year after completion of frontline treatment and are associated with significantly increased mortality; th

Condition(s)Diffuse Large B Cell Lymphoma
StatusRecruiting
PhasePhase 2
Study typeInterventional
SummaryA serious consequence of systemic diffuse large B-cell lymphoma (DLBCL) is secondary central nervous system (CNS) relapse, which occurs in approximately 5% of all patients. Many CNS relapses occur within the first year after completion of frontline treatment and are associated with significantly increased mortality; thus, it is important to tailor frontline treatment to provide prophylaxis against CNS relapse in those patients who are determined to be high-risk. Autologous stem cell transplantation (ASCT) is standard of care for patients with DLBCL who relapse one year or more after first remission, and it has been shown to improve progression-free survival for patients with primary CNS lymphoma. The four-drug BEAM regimen (carmustine, etoposide, cytarabine, and melphalan) is the preferred
Who can participateScreening Inclusion Criteria: * Newly diagnosed diffuse large B-cell lymphoma, large B-cell lymphoma transformed from underlying indolent lymphoma, or high-grade B-cell lymphoma. Patients with secondary CNS lymphoma are eligible. Patients with Richter's transformation are NOT eligible. * At high risk for CNS relapse prior to start of induction as defined by at least one of the criteria below: * CNS-IPI ≥ 4 * Kidney or adrenal involvement * Testicular involvement * Breast involvement * Ovarian involvement * Uterine involvement * Skin involvement * Double hit lymphoma as defined by containing translocations of MYC gene together with rearrangement of BCL2 and/or BCL6. * Bone marrow involvement * Myocardium involvement * CNS adjacent * Secondary CNS involvement * Intend to receive a full cours
Ages18 Years to 75 Years
SexAll
Lead sponsorWashington University School of Medicine
LocationsSt Louis, Missouri, United States
Start date2025-01-16
NCT IDNCT06687772
Official listinghttps://clinicaltrials.gov/study/NCT06687772

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