The risk for central nervous system (CNS) involvement is small in cases of diffuse large B-cell lymphoma (DLBCL) because only about 5% of patients develop it. But certain high-risk patients are even more likely to get it, and the consequences are likely to be devastating.

“This is a condition [that] has a poor prognosis with high mortality, and the treatments we use are intensified and associated with important side effects,” said hematologist-oncologist Andrés J.M. Ferreri, MD, of IRCCS San Raffaele Scientific Institute in Milan, Italy, in a debate at the 18th International Conference on Malignant Lymphoma (ICML) 2025 in Lugano, Switzerland .

Should patients with DLBCL undergo CNS prophylaxis? Ferreri argued that the answer is yes, “the prophylaxis must be done.” The only question is

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