Thi Yen Le

This study evaluated clinical characteristics, treatment outcomes, and CNS relapse patterns in patients with breast-involved diffuse large B-cell lymphoma (DLBCL), a rare extranodal presentation with limited real-world data. We conducted a retrospective study on 33 consecutive patients with newly diagnosed breast-involved DLBCL treated from 2019 to 2024. All patients received R-CHOP. Baseline CNS screening—including neurological examination, fundoscopy, brain magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis—was routinely performed. High-dose methotrexate (HD-MTX) was offered as CNS prophylaxis after completion of systemic therapy based on multidisciplinary team evaluation and clinician–patient shared decision-making according to institutional treatment protocols. Median age was 52.6 years; 84.8% had ECOG 0. Non-GCB subtype predominated (84.8%), and Ki-67 >70% was present in 69.7%. The overall response rate was 90.9%, with 84.8% complete responses. At a median follow-up of 44 months, 5-year Overall Survival (OS) and Progression-Free Survival (PFS) were 84.8% and 66.7%. CNS relapse occurred in 4 of 6 patients (66.7%) without prophylaxis, all within 5–11 months after R-CHOP, whereas no CNS relapses were observed among prophylaxis recipients (p < 0.001), although this observation should be interpreted with extreme caution given the very small non-prophylaxis subgroup (n = 6), limited statistical power, and non-randomized treatment allocation. Exploratory analyses suggested that bulky disease was associated with inferior OS. R-CHOP achieved high response rates and favorable long-term outcomes in breast-involved DLBCL. The absence of CNS relapse among HD-MTX prophylaxis recipients, contrasted with a high relapse rate in those without prophylaxis, provides only a hypothesis-generating observation that requires confirmation in larger prospective studies; this warrants further investigation of the role of systemic CNS prophylaxis.

Introduction: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL-NT), is a rare and aggressive lymphoma for which real-world data from resource-limited settings remain scarce. This study evaluated the efficacy and safety of frontline multimodal treatment strategies for localized ENKTL-NT. Methods: We retrospectively analyzed 62 patients with localized ENKTL-NT treated at the Vietnam National Cancer Hospital between May 2019 and June 2025. Patients received concurrent chemoradiotherapy followed by VIPD or VIDL, or sequential chemoradiotherapy with GELOX/PGEMOX. Treatment responses, survival outcomes, and toxicities were assessed. Results: The median age was 44 years, and 67.7% of patients had stage I disease. Baseline EBV-DNA positivity was detected in 46.8%, while 54.8% had PINKE scores of 1–2. The overall response rate was 93.5%, including an 85.5% complete response rate. Grade 3–4 neutropenia was the most common adverse event (18.7%). The estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 76.3% and 79.5%, respectively. Multivariable Cox analysis identified PINKE risk stratification as an independent predictor of both PFS and OS. Conclusions: Frontline multimodal treatment strategies achieved high response rates, favorable survival outcomes, and manageable toxicities in localized ENKTL-NT. The PINKE score remained an important prognostic factor, supporting risk-adapted treatment selection in routine clinical practice.

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in cancer patients, with lymphoma being recognized as a high-risk malignancy. Real-world evidence from Southeast Asia, particularly Vietnam, remains limited. This study aimed to assess the incidence and risk factors for VTE among newly diagnosed lymphoma patients receiving systemic therapy in a real-world clinical setting. We conducted a prospective descriptive study of 157 newly diagnosed Hodgkin and non-Hodgkin lymphoma patients treated at Vietnam National Cancer Hospital from January 2022 to January 2024. VTE risk was evaluated via the Khorana score at baseline and throughout chemotherapy. Doppler ultrasound and computed tomography were used for VTE screening. Multivariate logistic regression analysis identified independent risk factors for VTE. The incidence of VTE in this cohort was 8.3%, and patients were predominantly diagnosed at baseline (7.0%), with only two cases (1.3%) occurring during chemotherapy. The baseline Khorana risk assessment classified 68.2% of patients as low-risk and 7.6% as high-risk, with the proportion of high-risk patients decreasing progressively during treatment. Multivariate analysis revealed elevated pretreatment D-dimer levels (> 500 ng/mL; OR = 0.044, 95% CI: 0.003–0.632, p = 0.022) and cardiovascular comorbidities (OR = 0.036, 95% CI: 0.002–0.545, p = 0.016) as independent predictors of VTE. Newly diagnosed lymphoma patients presented an 8.3% incidence of VTE, primarily at initial diagnosis. Elevated D-dimer levels and cardiovascular comorbidities independently predict increased thrombotic risk. The incorporation of routine D-dimer measurements and comprehensive clinical evaluations into standard pretreatment assessments could improve prophylactic strategies and patient outcomes in lymphoma care.