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Detailed Long-Term Follow-Up of Patients Who Relapsed after the Nordic Mantle Cell Lymphoma Trials : MCL2 and MCL3

Eskelund, Christian Winther ; Dimopoulos, Kostas ; Kolstad, Arne ; Glimelius, Ingrid ; Räty, Riikka ; Gjerdrum, Lise Mette Rahbek ; Sonnevi, Kristina ; Josefsson, Pär ; Nilsson-Ehle, Herman and Bentzen, Hans H.N. , et al. (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.

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publishing date
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
2024-06-15 10:37:48
@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 &lt; 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}},
}