Detailed Long-Term Follow-Up of Patients Who Relapsed after the Nordic Mantle Cell Lymphoma Trials : MCL2 and MCL3
(2021) In HemaSphere 5(1).- Abstract
Mantle cell lymphoma (MCL) is an incurable disease with a highly variable clinical course. The prognosis after relapse is generally poor, and no standard of care exists. We investigated the postrelapse outcomes of 149 patients who were initially treated in the Nordic Lymphoma Group trials, MCL2 or MCL3, both representing intensive cytarabine-containing frontline regimens including autologous stem cell transplant. Patients with progression of disease before 24 months (POD24, n = 51, 34%) displayed a median overall survival of 6.6 months compared with 46 months for patients with later POD (n = 98, 66%; P < 0.001). MCL international prognostic index, cell proliferation marker, blastoid morphology, and TP53 mutations showed independent... (More)
Mantle cell lymphoma (MCL) is an incurable disease with a highly variable clinical course. The prognosis after relapse is generally poor, and no standard of care exists. We investigated the postrelapse outcomes of 149 patients who were initially treated in the Nordic Lymphoma Group trials, MCL2 or MCL3, both representing intensive cytarabine-containing frontline regimens including autologous stem cell transplant. Patients with progression of disease before 24 months (POD24, n = 51, 34%) displayed a median overall survival of 6.6 months compared with 46 months for patients with later POD (n = 98, 66%; P < 0.001). MCL international prognostic index, cell proliferation marker, blastoid morphology, and TP53 mutations showed independent prognostic value irrespective of POD24, and in a combined, exploratory risk score, patients with 0, 1, 2-3, or 4-5 high-risk markers, respectively, displayed a 5-year overall survival of 62%, 39%, 31%, and 0%. By a comparison of median progression-free survival of the different salvage therapies in the relapse setting, bendamustine-rituximab was superior to all other combination chemotherapy regimens; however, it was also associated with longer responses to last line of therapy. Collectively, we confirm the prognostic impact of POD24 and highlight the relevance of other biomarkers, and we emphasize the importance of novel therapies for patients with high-risk features at first POD.
(Less)
- author
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- HemaSphere
- volume
- 5
- issue
- 1
- article number
- e510
- publisher
- Wolters Kluwer
- external identifiers
-
- scopus:85104140837
- pmid:33364550
- ISSN
- 2572-9241
- DOI
- 10.1097/HS9.0000000000000510
- language
- English
- LU publication?
- no
- id
- 0c2fc935-6af5-4a11-a5cb-1702c2341586
- date added to LUP
- 2021-04-29 09:15:48
- date last changed
- 2024-09-08 17:42:14
@article{0c2fc935-6af5-4a11-a5cb-1702c2341586, abstract = {{<p>Mantle cell lymphoma (MCL) is an incurable disease with a highly variable clinical course. The prognosis after relapse is generally poor, and no standard of care exists. We investigated the postrelapse outcomes of 149 patients who were initially treated in the Nordic Lymphoma Group trials, MCL2 or MCL3, both representing intensive cytarabine-containing frontline regimens including autologous stem cell transplant. Patients with progression of disease before 24 months (POD24, n = 51, 34%) displayed a median overall survival of 6.6 months compared with 46 months for patients with later POD (n = 98, 66%; P < 0.001). MCL international prognostic index, cell proliferation marker, blastoid morphology, and TP53 mutations showed independent prognostic value irrespective of POD24, and in a combined, exploratory risk score, patients with 0, 1, 2-3, or 4-5 high-risk markers, respectively, displayed a 5-year overall survival of 62%, 39%, 31%, and 0%. By a comparison of median progression-free survival of the different salvage therapies in the relapse setting, bendamustine-rituximab was superior to all other combination chemotherapy regimens; however, it was also associated with longer responses to last line of therapy. Collectively, we confirm the prognostic impact of POD24 and highlight the relevance of other biomarkers, and we emphasize the importance of novel therapies for patients with high-risk features at first POD.</p>}}, author = {{Eskelund, Christian Winther and Dimopoulos, Kostas and Kolstad, Arne and Glimelius, Ingrid and Räty, Riikka and Gjerdrum, Lise Mette Rahbek and Sonnevi, Kristina and Josefsson, Pär and Nilsson-Ehle, Herman and Bentzen, Hans H.N. and Fagerli, Unn Merete and Kuittinen, Outi and Haaber, Jacob and Niemann, Carsten Utoft and Pedersen, Lone Bredo and Larsen, Maria Torp and Geisler, Christian Hartmann and Hutchings, Martin and Jerkeman, Mats and Grønbæk, Kirsten}}, issn = {{2572-9241}}, language = {{eng}}, number = {{1}}, publisher = {{Wolters Kluwer}}, series = {{HemaSphere}}, title = {{Detailed Long-Term Follow-Up of Patients Who Relapsed after the Nordic Mantle Cell Lymphoma Trials : MCL2 and MCL3}}, url = {{http://dx.doi.org/10.1097/HS9.0000000000000510}}, doi = {{10.1097/HS9.0000000000000510}}, volume = {{5}}, year = {{2021}}, }