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Nationwide Assessment of Patient Trajectories in Mantle Cell Lymphoma : The Swedish MCL complete Project

Jerkeman, Mats LU ; Ekberg, Sara LU ; Glimelius, Ingrid ; Albertsson-Lindblad, Alexandra LU ; Entrop, Joshua P. ; Ellin, Fredrik LU ; Sonnevi, Kristina ; Lewerin, Catharina ; Brandefors, Lena and Smedby, Karin E. (2023) In HemaSphere 7(8). p.928-928
Abstract

Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL. All patients diagnosed with MCL 2006-2018 were identified in the Swedish Lymphoma Register. Information on all lines of therapy was extracted from the medical records. Overall and progression-free survival (OS and PFS) were assessed through August 2021. In total, 1367 patients were included (median age, 71 years) and median follow-up was 6.8 years. Two hundred and one (15%) were managed initially with watch-and-wait, but 1235... (More)

Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL. All patients diagnosed with MCL 2006-2018 were identified in the Swedish Lymphoma Register. Information on all lines of therapy was extracted from the medical records. Overall and progression-free survival (OS and PFS) were assessed through August 2021. In total, 1367 patients were included (median age, 71 years) and median follow-up was 6.8 years. Two hundred and one (15%) were managed initially with watch-and-wait, but 1235 (90%) eventually received treatment. The most frequently used first-line regimens were rituximab-bendamustine (BR) (n = 368; 30%) and Nordic MCL2 (n = 342; 28%). During follow-up, 630 patients (46%) experienced relapse/progression and 546 (40%) received second-line treatment. The most frequently used second-line regimen was BR (n = 185; 34%) but otherwise a wide variety of second-line treatments were used. Further, 382 and 228 patients experienced a second or third relapse/progression, respectively. Median PFS after first (PFS-1), second (PFS-2), third (PFS-3), and fourth (PFS-4) treatment lines was 29.4, 8.9, 4.3, and 2.7 months. Patients with early progression, defined as a PFS-1 <24 months, had an inferior median OS of 13 versus 37 months in patients with later relapse. For patients treated with frontline BR, however, time to relapse had no impact on later outcome. By use of nationwide population-based data, we provide important benchmarks for future studies of all treatment lines in MCL.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
HemaSphere
volume
7
issue
8
pages
928 - 928
publisher
Wolters Kluwer
external identifiers
  • pmid:37529083
  • scopus:85167517256
ISSN
2572-9241
DOI
10.1097/HS9.0000000000000928
language
English
LU publication?
yes
id
de5da5e5-c1e5-481a-a57d-8676df9ed237
date added to LUP
2023-10-30 13:31:51
date last changed
2024-04-19 03:01:52
@article{de5da5e5-c1e5-481a-a57d-8676df9ed237,
  abstract     = {{<p>Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL. All patients diagnosed with MCL 2006-2018 were identified in the Swedish Lymphoma Register. Information on all lines of therapy was extracted from the medical records. Overall and progression-free survival (OS and PFS) were assessed through August 2021. In total, 1367 patients were included (median age, 71 years) and median follow-up was 6.8 years. Two hundred and one (15%) were managed initially with watch-and-wait, but 1235 (90%) eventually received treatment. The most frequently used first-line regimens were rituximab-bendamustine (BR) (n = 368; 30%) and Nordic MCL2 (n = 342; 28%). During follow-up, 630 patients (46%) experienced relapse/progression and 546 (40%) received second-line treatment. The most frequently used second-line regimen was BR (n = 185; 34%) but otherwise a wide variety of second-line treatments were used. Further, 382 and 228 patients experienced a second or third relapse/progression, respectively. Median PFS after first (PFS-1), second (PFS-2), third (PFS-3), and fourth (PFS-4) treatment lines was 29.4, 8.9, 4.3, and 2.7 months. Patients with early progression, defined as a PFS-1 &lt;24 months, had an inferior median OS of 13 versus 37 months in patients with later relapse. For patients treated with frontline BR, however, time to relapse had no impact on later outcome. By use of nationwide population-based data, we provide important benchmarks for future studies of all treatment lines in MCL.</p>}},
  author       = {{Jerkeman, Mats and Ekberg, Sara and Glimelius, Ingrid and Albertsson-Lindblad, Alexandra and Entrop, Joshua P. and Ellin, Fredrik and Sonnevi, Kristina and Lewerin, Catharina and Brandefors, Lena and Smedby, Karin E.}},
  issn         = {{2572-9241}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{928--928}},
  publisher    = {{Wolters Kluwer}},
  series       = {{HemaSphere}},
  title        = {{Nationwide Assessment of Patient Trajectories in Mantle Cell Lymphoma : The Swedish MCL complete Project}},
  url          = {{http://dx.doi.org/10.1097/HS9.0000000000000928}},
  doi          = {{10.1097/HS9.0000000000000928}},
  volume       = {{7}},
  year         = {{2023}},
}