Ten-year follow-up after intense chemoimmunotherapy with Rituximab-HyperCVAD alternating with Rituximab-high dose methotrexate/cytarabine (R-MA) and without stem cell transplantation in patients with untreated aggressive mantle cell lymphoma

Jorge E. Romaguera, Luis E. Fayad, Lei Feng, Kimberly Hartig, Pamela Weaver, Maria Alma Rodriguez, Fredrick B. Hagemeister, Barbara Pro, Peter McLaughlin, Anas Younes, Felipe Samaniego, Andre Goy, Fernando Cabanillas, Hagop Kantarjian, Larry Kwak, Michael Wang

Research output: Contribution to journalArticlepeer-review

211 Scopus citations

Abstract

Mantle cell lymphoma (MCL) has a poor overall survival after treatment with conventional chemotherapy. Intense chemoimmunotherapy without consolidation stem cell transplantation is a potential therapeutic option. We report on a prospective Phase II study with rituximab in combination with fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone (R-Hyper-CVAD) alternating with rituximab in combination with high-dose methotrexate-cytarabine (R-MA) in untreated patients with diffuse and nodular MCL and their blastoid variants. Ninety-seven patients were treated, of whom 97% responded and 87% achieved a complete remission. At 10 years of follow up (median 8 years), the median overall survival (OS) for all patients had not been reached and the median time to failure (TTF) for all patients was 4.6 years, without a plateau in the curves. For the group of patients aged 65 years or younger, the median OS had not been reached and the median TTF was 5.9 years. Multivariate analysis revealed pre-treatment serum levels of β2 microglobulin, International Prognostic Index (IPI) score and mantle cell IPI (MIPI) score, as predictive of both OS and TTF. We conclude that intense chemoimmunotherapy without stem cell transplantation is effective for untreated aggressive MCL.

Original languageEnglish (US)
Pages (from-to)200-208
Number of pages9
JournalBritish Journal of Haematology
Volume150
Issue number2
DOIs
StatePublished - Jul 2010

Keywords

  • hyper-CVAD
  • mantle cell lymphoma
  • methotrexate-cytarabine
  • rituximab
  • survival

ASJC Scopus subject areas

  • Hematology

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