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Validation of POD24 as a robust early clinical indicator of poor survival in mantle cell lymphoma from 1280 patients on clinical trials, a LYSA study

Sarkozy, Clémentine ; Chartier, Loïc ; Ribrag, Vincent ; Gressin, Remy ; Geisler, Christian H. ; Kluin-Nelemans, Hanneke C. ; Thieblemont, Catherine ; Morschhauser, Franck ; Lemonnier, François and Safar, Violaine , et al. (2025) In Blood Cancer Journal 15(1).
Abstract

In mantle cell lymphoma, early progression of disease has been associated with short overall survival. The impact of clinical, pathological, and treatment strategies on the risk of early relapse has not been assessed in a large cohort of patients. We performed a pooled analysis of patients recruited in France from six randomized first-line MCL trials. Among 1386 treated MCL patients, 1280 were evaluable for POD24 status: 299 (23.4%) with a POD24 event and 981 (76.6%) without. Patients with a POD24 event had a median OS of 9.3 months (95% CI 8.4–11.8) versus not reached (95% CI 97.8–NR) for those without POD24 events. The median post-relapse OS of patients with a late relapse was also significantly longer at 49.4 months (HR = 0.39; 95%... (More)

In mantle cell lymphoma, early progression of disease has been associated with short overall survival. The impact of clinical, pathological, and treatment strategies on the risk of early relapse has not been assessed in a large cohort of patients. We performed a pooled analysis of patients recruited in France from six randomized first-line MCL trials. Among 1386 treated MCL patients, 1280 were evaluable for POD24 status: 299 (23.4%) with a POD24 event and 981 (76.6%) without. Patients with a POD24 event had a median OS of 9.3 months (95% CI 8.4–11.8) versus not reached (95% CI 97.8–NR) for those without POD24 events. The median post-relapse OS of patients with a late relapse was also significantly longer at 49.4 months (HR = 0.39; 95% CI 0.31–0.48; P < 0.001) as compared to POD24 patients. Baseline variables (age, performance status, B symptoms, LDH/ULN, leukocytes, blastoid variant, and Ki-67 > 30%) were significantly associated with the risk of POD24, independent of ASCT. Among responding patients at end-of-induction (n = 1105) who had received ASCT, anti-CD20 maintenance was associated with a decreased risk of POD24 (OR = 0.37; 95% CI 0.1–1.0). Using this large data set of patients in clinical trials, we confirm that POD24 status is strongly associated with subsequent OS in MCL. Rituximab maintenance provided significant protection against the risk of POD24, independent of ASCT. Progression within 2 years should be considered as a primary endpoint in future studies.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood Cancer Journal
volume
15
issue
1
article number
78
publisher
Nature Publishing Group
external identifiers
  • pmid:40274771
  • scopus:105003477024
ISSN
2044-5385
DOI
10.1038/s41408-025-01241-9
language
English
LU publication?
yes
id
c35e744b-f0ed-4d16-be7e-916209c9e26c
date added to LUP
2025-07-14 09:17:06
date last changed
2025-07-15 03:00:08
@article{c35e744b-f0ed-4d16-be7e-916209c9e26c,
  abstract     = {{<p>In mantle cell lymphoma, early progression of disease has been associated with short overall survival. The impact of clinical, pathological, and treatment strategies on the risk of early relapse has not been assessed in a large cohort of patients. We performed a pooled analysis of patients recruited in France from six randomized first-line MCL trials. Among 1386 treated MCL patients, 1280 were evaluable for POD24 status: 299 (23.4%) with a POD24 event and 981 (76.6%) without. Patients with a POD24 event had a median OS of 9.3 months (95% CI 8.4–11.8) versus not reached (95% CI 97.8–NR) for those without POD24 events. The median post-relapse OS of patients with a late relapse was also significantly longer at 49.4 months (HR = 0.39; 95% CI 0.31–0.48; P &lt; 0.001) as compared to POD24 patients. Baseline variables (age, performance status, B symptoms, LDH/ULN, leukocytes, blastoid variant, and Ki-67 &gt; 30%) were significantly associated with the risk of POD24, independent of ASCT. Among responding patients at end-of-induction (n = 1105) who had received ASCT, anti-CD20 maintenance was associated with a decreased risk of POD24 (OR = 0.37; 95% CI 0.1–1.0). Using this large data set of patients in clinical trials, we confirm that POD24 status is strongly associated with subsequent OS in MCL. Rituximab maintenance provided significant protection against the risk of POD24, independent of ASCT. Progression within 2 years should be considered as a primary endpoint in future studies.</p>}},
  author       = {{Sarkozy, Clémentine and Chartier, Loïc and Ribrag, Vincent and Gressin, Remy and Geisler, Christian H. and Kluin-Nelemans, Hanneke C. and Thieblemont, Catherine and Morschhauser, Franck and Lemonnier, François and Safar, Violaine and Tessoulin, Benoît and Oberic, Lucie and Damaj, Ghandi and Ghesquières, Hervé and Bouabdallah, Krimo and Casasnovas, René Olivier and Houot, Roch and Klapper, Wolfram and Burroni, Barbara and Pott, Christiane and Delfau-Larue, Marie Hélène and Macintyre, Elizabeth and Callanan, Mary and Jerkeman, Mats and Unterhalt, Michael and Hoster, Eva and Dreyling, Martin and Le Gouill, Steven and Hermine, Olivier and Cheminant, Morgane}},
  issn         = {{2044-5385}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Blood Cancer Journal}},
  title        = {{Validation of POD24 as a robust early clinical indicator of poor survival in mantle cell lymphoma from 1280 patients on clinical trials, a LYSA study}},
  url          = {{http://dx.doi.org/10.1038/s41408-025-01241-9}},
  doi          = {{10.1038/s41408-025-01241-9}},
  volume       = {{15}},
  year         = {{2025}},
}