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Impact of diagnosis to treatment interval in patients with newly diagnosed mantle cell lymphoma
Journal article   Open access   Peer reviewed

Impact of diagnosis to treatment interval in patients with newly diagnosed mantle cell lymphoma

Narendranath Epperla, Jeffrey Switchenko, Veronika Bachanova, James N. Gerson, Stefan K. Barta, Max J. Gordon, Alexey V. Danilov, Natalie S. Grover, Stephanie Mathews, Madelyn Burkart, …
Blood advances, Vol.7(11), pp.2287-2296
05/24/2023
DOI: 10.1182/bloodadvances.2022009225
PMCID: PMC10225877
PMID: 36516079
url
https://doi.org/10.1182/bloodadvances.2022009225View
Published (Version of record) Open Access

Abstract

•DTI is strongly associated with adverse clinical factors and inferior survival outcomes in patients with newly diagnosed MCL.•DTI should be reported in all patients newly diagnosed with MCL enrolling in clinical trials; steps must be taken to avoid selection bias. [Display omitted] The prognostic relevance of diagnosis to treatment interval (DTI) in patients with newly diagnosed mantle cell lymphoma (MCL) is unknown. Hence, we sought to evaluate the impact of DTI on outcomes in MCL using 3 large datasets (1) the University of Iowa/Mayo Clinic Specialized Program of Research Excellence Molecular Epidemiology Resource, (2) patients enrolled in the ALL Age Asthma Cohort/CALGB 50403, and (3) a multisitecohort of patients with MCL. Patients were a priori divided into 2 groups, 0 to 14 days (short DTI) and 15 to 60 days (long DTI). The patients in whom observation was deemed appropriate were excluded. 1097 patients newly diagnosed with MCL and available DTI were included in the study. The majority had long DTI. Patients with short DTI had worse eastern cooperative oncology group performance status), higher lactate dehydrogenase, bone marrow involvement, more frequent B symptoms, higher MCL International Prognostic Index (MIPI), and were less likely to receive intensive induction therapy than long DTI group. The median progression-free survival and overall survival were significantly inferior in the short DTI group than the long DTI cohort and remained significant for progression-free survival and overall survival in multivariable analysis. We show that the DTI is an important prognostic factor in patients newly diagnosed with MCL and is strongly associated with adverse clinical factors and poor outcomes. DTI should be reported in all the patients newly diagnosed with MCL who are enrolling in clinical trials and steps must be taken to ensure selection bias is avoided.

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