Abstract
MCL-042: Evolving Frontline Immunochemotherapy for Mantle Cell Lymphoma and the Impact on Survival Outcomes
Clinical lymphoma, myeloma and leukemia, Vol.21, pp.S408-S408
09/2021
DOI: 10.1016/S2152-2650(21)01919-4
Abstract
The frontline treatment for mantle cell lymphoma (MCL) has evolved in the past two decades.
To characterize changes in frontline treatment and the impact on outcomes in MCL patients.
Prospective cohort study of MCL diagnosed in Era 1 (2002–2009) vs Era 2 (2010–2015).
Academic centers.
Patients with newly diagnosed MCL who enrolled in the University of Iowa/Mayo Clinic Lymphoma SPORE MER cohort study.
Management per treating physician and prospective follow-up through MER.
Event-free survival (EFS) and overall survival (OS).
343 patients were included, 175 from Era 1 (median follow-up 13.0 years) and 168 from Era 2 (median follow-up 6.9 years). Age, sex, and sMIPI were similar between the 2 groups. For patients ≤65, there was less use of R-Hyper-CVAD (16.1% vs 8.8%) but more Nordic and R-CHOP/R-DHAP regimens (1.1% vs 26.4%) in Era 2; and less use of R-CHOP/R-CHOP-like regimen (64.5% vs 35.2%) but more R-Benda (0% vs 12.1%). Proportions of patients who underwent ASCT were similar (45.2% vs 44.4%). EFS (5-yr: 35.4% vs 51.7%, p=0.0107) and OS (5-yr: 68.8% vs 81.4%, p=0.0458) for patients ≤65 improved in Era 2. The improvement was driven by improved EFS (5-yr: 36.8% vs 54.7%, p=0.0145) and OS (5-yr: 69.7% vs 83.5%, p=0.0344) in patients who received standard immunochemotherapy (R-HyperCVAD, Nordic regimen, R-CHOP/R-DHAP, R-CHOP/R-CHOP-like, R-Benda). For patients with age >65, there was less use of R-CHOP/R-CHOP-like regimen (39.0% vs 14.3%) and non-standard systemic therapy (36.6% vs 13.0%) but more use of BR (0% vs 49.4%). There was a trend for improved EFS (5-yr: 25.4% vs 38.1%, p=0.0718) and OS (5-yr: 48.2% vs 54.1%, p=0.151) for patients > 65 in Era 2. The shift from R-CHOP/R-CHOP-like regimen to R-Benda led to improved EFS (5-yr: 25.0% vs 44.4%, p=0.0177) in Era 2.
Change in induction regimens resulted in improved EFS and OS in younger patients, and a shift from R-CHOP/R-CHOP-like regimen to R-Benda improved EFS in older patients. Results from this prospectively followed cohort provide critical real-world evidence for improved outcomes with evolving patterns of care in patients with MCL.
Details
- Title: Subtitle
- MCL-042: Evolving Frontline Immunochemotherapy for Mantle Cell Lymphoma and the Impact on Survival Outcomes
- Creators
- Yucai Wang - Mayo ClinicAlessia Castellino - Mayo Clinic, Rochester, MN, USAMelissa C. Larson - Mayo ClinicMatthew J. Maurer - Mayo ClinicBrian K. Link - University of IowaUmar Farooq - University of IowaDavid J. Inwards - Mayo ClinicStephen M. Ansell - Mayo ClinicThomas E. Witzig - Mayo ClinicThomas M. Habermann - Mayo ClinicJames R. Cerhan - Mayo ClinicGrzegorz S. Nowakowski - Mayo Clinic
- Resource Type
- Abstract
- Publication Details
- Clinical lymphoma, myeloma and leukemia, Vol.21, pp.S408-S408
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S2152-2650(21)01919-4
- ISSN
- 2152-2650
- eISSN
- 2152-2669
- Language
- English
- Date published
- 09/2021
- Academic Unit
- Epidemiology; Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984362356002771
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