Efficacy of intravenous high-dose methotrexate in preventing relapse to the central nervous system in R-CHOP(-like)-treated, high-risk, diffuse large B-cell lymphoma patients and its effect on mortality: A systematic review and meta-analysis

Results from a systematic review and meta-analysis of patients with DLBCL at high risk of CNS relapse treated with R-CHOP or similar found that those receiving prophylactic HD-MTX had a statistically nonsignificant relative risk (RR) of 0.54 (95% CI: 0.27-1.07) of CNS relapse vs those receiving no prophylaxis and/or IT prophylaxis. The meta-analysis investigating mortality demonstrated a RR of death of 0.70 (95% CI: 0.44-1.11) for HD-MTX treated patients vs the no and/or IT prophylaxis arm.