Sandoval-Sus, Jose
Mayo Clinic
Moffitt Malignant Hematology at Memorial Healthcare System, Pembroke Pines, FL.
Citations 1
Treatment-related outcomes and patterns of relapse in secondary CNS involvement by large B-cell lymphoma
Alderuccio, Juan Pablo , Baggio, Diva , Han, Sunwoo , Nizamuddin, Imran , Saha, Aditi, Dong, Ning , Wang, Yucai, Cherng, Hua‐Jay J. , Wagner-Johnston, Nina D., Desai, Amrita, Geethakumari, Praveen Ramakrishnan , Moyo, Tamara K. , Sandoval‐Sus, Jose , EPPERLA, NARENDRANATH, Kamdar, Manali, Tavarozzi, Rita , Danilov, A., Tun, H., Munoz, Javier, Narkhede, Mayur , Maraj, Adrian Matthew, Osborne, Wendy , Calvert, Victoria, El‐Sharkawi, Dima , Hilali, Ammar, Collins, Graham P., Elmusharaf, Nagah, Santarsieri, Anna , Karim, Farheen, Monick, Sarah, Trutzer, Iris Margalit, Can, Jones, Ayers, Amy , Feo, Jacopo Calabrese De, Ghosh, Nilanjan, Treitman, Rachel, Okcu, Izel, Hann, William D., Barrett, Aisling , Deshani, Vismay, Cwynarski, K., Wang, Yucai , Saha, Aditi , Ghione, Paola , Khwaja, Jahanzaib , Saha, Aditi , Wang, Yucai , Cherng, Hua-Jay J , Tolu, Seda , Wagner-Johnston, Nina , Ollila, Thomas A , Grover, Natalie S , Koff, Jean L , Ramakrishnan Geethakumari, Praveen , Sandoval-Sus, Jose , Epperla, Narendranath , Wallace, Danielle S , Kamdar, Manali , Tun, Han W , Narkhede, Mayur S , Rhodes, Joanna , Okosun, Jessica , El-Sharkawi, Dima , Collins, Graham P , Linton, Kim M , Santarsieri, Anna , Baidoun, Firas , Monick, Sarah E, Calabrese De Feo, Jacopo , Sharp, John , Ghosh, Nilanjan , Okcu, Izel , Hann, William , Barrett, Aisling , Deshani, Vismay , Kahl, Brad S , Chavez, Julio C , Olszewski, Adam J , Ghione, Paola , Dong, Ning, Wagner‐Johnston, Nina D. , Grover, Natalie S. , Koff, Jean L. , Epperla, Narendranath , Wallace, Danielle , Kamdar, Manali , Tun, Han W. , Muñoz, Javier, Rhodes, Joanna , Prica, Anca A. , Kühnl, Andrea , Maraj, Adrian , Smith, Jeff , Calvert, Victoria, Linton, Kim , Baidoun, Firas , Sharp, John , Kallam, Avyakta , Abeyakoon, Chathuri , Kahl, Brad S. , Olszewski, Adam J. , Cwynarski, Kate
Blood | January 5, 2026 | Volume: 147 | Issue: 16 | Pages: 1814-1827
Abstract Secondary central nervous system (CNS) large B-cell lymphoma (SCNSL) occurs in the de novo setting, as a CNS-isolated relapse, or synchronous (concomitant CNS and systemic) relapse. SCNSL is a devastating event without therapeutic consensus. Thus, we aimed to evaluate treatment outcomes in an international cohort. Progression-free survival (PFS), overall survival (OS), and cumulative incidence of relapse (CIR, estimated using competing-risk models) were reported. Prognostic factors were identified in a 6-month landmark multivariate analysis. Outcomes after thiotepa autologous stem cell transplant (ASCT) and chimeric antigen receptor (CAR) T-cell therapy (CAR-T) delivered at relapse were compared after propensity score matching (PSM). A total of 1139 patients were included in the analysis (de novo: 537; relapsed SCNSL: 602). Two-year PFS estimates were 40.4%, 43.9%, and 16.2% for de novo SCNSL, CNS-isolated relapse, and synchronous relapse, respectively. Patients with CNS-isolated relapse demonstrated low rates of systemic recurrence (24-month CIR, 6%). Thiotepa-ASCT correlated with longer survival in de novo SCNSL (PFS: hazard ratio [HR], 0.57; P = .005; and OS: HR, 0.62; P = .023) and CNS-isolated relapses (PFS: HR, 0.55; P = .002; and OS: HR, 0.39; P< .0001). ASCT (thiotepa or no thiotepa) also associated with improved survival in synchronous relapses (PFS: HR, 0.57; P = .023; and OS: HR, 0.48; P = .019). Higher survival with thiotepa-ASCT than CAR-T was observed after PSM (PFS: HR, 0.45; P = .005 and OS: HR, 0.41; P = .014). These data support thiotepa-ASCT in eligible patients, particularly de novo disease and CNS-isolated relapses. CNS-isolated relapse was infrequently associated with systemic recurrence, supporting treatment regimens adopted from primary CNS lymphoma.