Evolving Frontline Immunochemotherapy for Mantle Cell Lymphoma and the Impact on Survival Outcomes

Alessia Castellino; Yucai Wang; Melissa C Larson; Matthew J Maurer; Brian K Link; Umar Farooq; Andrew Feldman; Sergei I Syrbu; Thomas M Habermann; Jonas Paludo; David J Inwards; Thomas E Witzig; Stephen M Ansell; Cristine Allmer; Susan L Slager; Jonathon B Cohen; Peter Martin; James R Cerhan; Grzegorz S Nowakowski

doi:10.1182/bloodadvances.2021005715

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Evolving Frontline Immunochemotherapy for Mantle Cell Lymphoma and the Impact on Survival Outcomes

Journal article

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Evolving Frontline Immunochemotherapy for Mantle Cell Lymphoma and the Impact on Survival Outcomes

Alessia Castellino, Yucai Wang, Melissa C Larson, Matthew J Maurer, Brian K Link, Umar Farooq, Andrew Feldman, Sergei I Syrbu, Thomas M Habermann, Jonas Paludo, …

Blood advances, Vol.6(4), pp.1350-1360

10/18/2021

DOI: 10.1182/bloodadvances.2021005715

PMCID: PMC8864651

PMID: 34662895

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Abstract

With the advances in mantle cell lymphoma (MCL) frontline treatment over the last two decades, we sought to characterize the frontline treatment pattern change and its association with outcomes. Patients with newly diagnosed MCL from September 2002 through June 2015 were enrolled in a prospective cohort study, and clinical characteristics, treatment, and clinical outcomes were compared between patients diagnosed in 2002-2009 (Era 1) vs 2010-2015 (Era 2). Patient age, sex and simplified MIPI score were similar between the two groups. In patients with an age ≤65, there were 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%), and less use of R-CHOP/R-CHOP-like regimen (64.5% vs 35.2%) but more R-Bendamustine (0% vs 12.1%) in Era 2 (p<0.001). These changes were associated with improved EFS (5-year 34.3% vs 50.0%, p=0.010) and OS (5-year 68.8% vs 81.6%, p=0.017) in Era 2. In patients with an age >65, there were less use of R-CHOP/R-CHOP-like (39.0% vs 14.3%) and non-standard systemic therapy (36.6% vs 13.0%) but more R-Bendamustine (0% vs 49.4%). These changes were associated with a trend for improved EFS (5-year 25.4% vs 37.5%, p=0.051) in Era 2. The shift from R-CHOP/R-CHOP-like regimen to R-Bendamustine was associated with improved EFS (5-year 25.0% vs 44.6%, p=0.008) in Era 2. Results from this prospective cohort study provide critical real-world evidence for improved outcomes with evolving frontline pattern of care in patients with MCL.

Details

Title: Subtitle: Evolving Frontline Immunochemotherapy for Mantle Cell Lymphoma and the Impact on Survival Outcomes
Creators: Alessia Castellino - Santa Croce e Carle Hospital, Italy.
Yucai Wang - Mayo Clinic
Melissa C Larson - Mayo Clinic
Matthew J Maurer - Mayo Clinic
Brian K Link - University of Iowa
Umar Farooq - University of Iowa Hospitals and Clinics
Andrew Feldman - Mayo Clinic
Sergei I Syrbu - University of Iowa
Thomas M Habermann - Mayo Clinic
Jonas Paludo - Mayo Clinic
David J Inwards - Mayo Clinic
Thomas E Witzig - Mayo Clinic
Stephen M Ansell - Mayo Clinic
Cristine Allmer - Mayo Clinic
Susan L Slager - Mayo Clinic
Jonathon B Cohen - Cornell University
Peter Martin - Emory University
James R Cerhan - Mayo Clinic in Florida
Grzegorz S Nowakowski - Mayo Clinic
Resource Type: Journal article
Publication Details: Blood advances, Vol.6(4), pp.1350-1360
DOI: 10.1182/bloodadvances.2021005715
PMID: 34662895
PMCID: PMC8864651
NLM abbreviation: Blood Adv
ISSN: 2473-9529
eISSN: 2473-9537
Language: English
Date published: 10/18/2021
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9984201422902771

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