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J Clin Oncol. 2019 Feb 20;37(6):471-480. doi: 10.1200/JCO.18.00690. Epub 2019 Jan 7.

Survival Outcomes of Younger Patients With Mantle Cell Lymphoma Treated in the Rituximab Era.

Author information

1
1 Fox Chase Cancer Center, Philadelphia, PA.
2
2 BC Cancer, Vancouver, British Columbia, Canada.
3
3 MD Anderson Cancer Center, Houston, TX.
4
4 Emory University, Atlanta, GA.
5
5 Cleveland Clinic Foundation, Cleveland, OH.
6
6 Roswell Park Cancer Institute, Buffalo, NY.
7
7 University of Nebraska Cancer Center, Omaha, NE.
8
8 Medical College of Wisconsin, Milwaukee, WI.
9
9 Ohio State University; Columbus, OH.
10
10 University of Minnesota, Minneapolis, MN.
11
11 Moffitt Cancer Center, Tampa, FL.
12
12 Dartmouth-Hitchcock Medical Center, Lebanon, NH.
13
13 Johns Hopkins University, Baltimore, MD.
14
14 University of Alabama Cancer Center, Birmingham, AL.
15
15 Vanderbilt Ingram Cancer Center, Nashville, TN.
16
16 University of Pennsylvania, Philadelphia, PA.
17
17 Huntsman Cancer Institute, Salt Lake City, UT.
18
18 Mayo Clinic, Rochester, MN.
19
19 Northwestern University, Evanston, IL.
20
20 Case Western Reserve University, Cleveland, OH.
21
21 University of Wisconsin, Madison, WI.
22
22 Tufts University, Boston, MA.
23
23 University of Vermont, Burlington, VT.
24
24 Columbia University, New York, NY.
25
25 New York University, New York, NY.

Abstract

PURPOSE:

Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.

PATIENTS AND METHODS:

We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score-weighted (PSW) analysis were performed.

RESULTS:

Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).

CONCLUSION:

In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.

PMID:
30615550
DOI:
10.1200/JCO.18.00690

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