What question did this study set out to answer?

The study aims to assess the effectiveness of high-dose methotrexate for preventing CNS relapse in ultra high-risk large B-cell lymphoma patients.

High-Dose Methotrexate as CNS Prophylaxis in Ultra High-Risk Large B-Cell Lymphoma: An International Multicenter Analysis

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Randomized trial explores high-dose methotrexate’s effect on CNS relapse in ultra high-risk lymphoma patients, suggesting limited benefit.

The study aims to assess the effectiveness of high-dose methotrexate for preventing CNS relapse in ultra high-risk large B-cell lymphoma patients.
Combined data from two retrospective analyses for a cohort of 1,923 ultra high-risk patients.
Evaluated CNS relapse rates in patients treated with and without high-dose methotrexate.
Conducted multivariable analyses to adjust for baseline characteristics.
No significant difference in 3-year CNS relapse rates observed (9.3% without HD-MTX vs. 8.1% with HD-MTX; adjusted HR 1.13 [95% CI, 0.82 to 1.57]).
CNS relapse rates for isolated CNS relapse showed no difference (5.9% vs. 5.7%; adjusted HR 1.03 [95% CI, 0.69 to 1.53]).
Landmark analysis also indicated no difference in CNS relapse rates (6.7% vs. 6.6%, adjusted HR 0.95 [95% CI, 0.62 to 1.44]).

Wilson et al. (2026) studied this question.

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Randomized trial explores high-dose methotrexate’s effect on CNS relapse in ultra high-risk lymphoma patients, suggesting limited benefit.