TY - JOUR
T1 - Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era
AU - Gerson, James N.
AU - Handorf, Elizabeth
AU - Villa, Diego
AU - Gerrie, Alina S.
AU - Chapani, Parv
AU - Li, Shaoying
AU - Jeffrey Medeiros, L.
AU - Wang, Michael I.
AU - Cohen, Jonathon B.
AU - Calzada, Oscar
AU - Churnetski, Michael C.
AU - Hill, Brian T.
AU - Sawalha, Yazeed
AU - Hernandez-Ilizaliturri, Francisco J.
AU - Kothari, Shalin
AU - Vose, Julie M.
AU - Bast, Martin A.
AU - Fenske, Timothy S.
AU - Gari, Swapna Narayana Rao
AU - Maddocks, Kami J.
AU - Bond, David
AU - Bachanova, Veronika
AU - Kolla, Bhaskar
AU - Chavez, Julio
AU - Shah, Bijal
AU - Lansigan, Frederick
AU - Burns, Timothy F.
AU - Donovan, Alexandra M.
AU - Wagner-Johnston, Nina
AU - Messmer, Marcus
AU - Mehta, Amitkumar
AU - Anderson, Jennifer K.
AU - Reddy, Nishitha
AU - Kovach, Alexandra E.
AU - Landsburg, Daniel J.
AU - Glenn, Martha
AU - Inwards, David J.
AU - Karmali, Reem
AU - Kaplan, Jason B.
AU - Caimi, Paolo F.
AU - Rajguru, Saurabh
AU - Evens, Andrew
AU - Klein, Andreas
AU - Umyarova, Elvira
AU - Pulluri, Bhargavi
AU - Amengual, Jennifer E.
AU - Lue, Jennifer K.
AU - Diefenbach, Catherine
AU - Fisher, Richard I.
AU - Barta, Stefan K.
N1 - Publisher Copyright:
© 2019 by American Society of Clinical Oncology.
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
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U2 - 10.1200/JCO.18.00690
DO - 10.1200/JCO.18.00690
M3 - Article
C2 - 30615550
AN - SCOPUS:85061614115
SN - 0732-183X
VL - 37
SP - 471
EP - 480
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 6
ER -
