Journal article
Long-term survival and cause-specific mortality after event-free survival at 24 months (EFS24) in mantle cell lymphoma: an international multicohort study
Blood cancer journal (New York)
09/22/2026
DOI: 10.1038/s41408-026-01625-5
Abstract
The prognostic significance of event-free survival at 24 months (EFS24) in mantle cell lymphoma (MCL) has not been fully defined in the era of contemporary immunochemotherapy. We analyzed 3179 patients from five cohorts (Mayo Clinic/Iowa MER, US 12-center, BC Cancer, Swedish, and Danish) diagnosed between 2002 and 2020. Two treatment eras were defined per cohort based on shifts in frontline immunochemotherapy. In the MER cohort, patients achieving EFS24 in the earlier era had inferior OS compared with age- and sex-matched general population (standardized mortality ratio [SMR] = 2.36, 95% CI 1.74–3.14), whereas survival approached expected OS in the contemporary era (SMR = 1.38, 95% CI 0.90–2.02). After EFS24, lymphoma remained the leading cause of death in the earlier era (5-year lymphoma vs non-lymphoma mortality 18% vs 8%) but not in the contemporary era (8% vs 9%). Similar trends were observed in other cohorts. Post-EFS24 survival approached that of the general population in the US 12-center cohort (SMR = 1.44) in the contemporary era, and improved from earlier to contemporary eras in BC Cancer (SMR 4.99 vs 3.56), Swedish (SMR 4.26 vs 3.17), and Danish (SMR 2.36 vs 2.23) cohorts. In the contemporary era, 5-year lymphoma-related mortality was comparable to or lower than other mortality: 12% vs 12% in BC Cancer, 6% vs 9% in US 12-center, and 13% vs 18% in Swedish cohorts. These findings demonstrate that achieving EFS24 in MCL is associated with improved conditional survival approaching general population expectations and declining lymphoma-related mortality in the era of contemporary immunochemotherapy.
Details
- Title: Subtitle
- Long-term survival and cause-specific mortality after event-free survival at 24 months (EFS24) in mantle cell lymphoma: an international multicohort study
- Creators
- Yucai Wang - Mayo ClinicMelissa C. Larson - Mayo ClinicUmar Farooq - University of IowaSara EkbergKarin E. Smedby - Karolinska InstitutetMikkel R. Simonsen - Aalborg University HospitalPeter de Nully Brown - Copenhagen University HospitalCarsten U. Niemann - Copenhagen University HospitalEric J. Zhao - University of British ColumbiaAlina S. Gerrie - University of British ColumbiaJeffrey M. Switchenko - Emory UniversityDavid A. Bond - The Ohio State UniversityVeronika Bachanova - University of MinnesotaStefan K. Barta - University of PennsylvaniaBrian T. Hill - Cleveland ClinicPeter Martin - Weill Cornell MedicineAlexey V. Danilov - City Of Hope National Medical CenterNatalie S. Grover - University of North Carolina at Chapel HillReem Karmali - Northwestern UniversityNilanjan Ghosh - Levine Cancer InstituteTimothy S. Fenske - Medical College of WisconsinBrad S. Kahl - Washington University in St. LouisAlexandra Albertsson-Lindblad - Lund UniversityIngrid Glimelius - Uppsala UniversityAhmed Ludvigsen Al-Mashhadi - Aarhus University HospitalThomas S. Larsen - Odense University HospitalKami J. Maddocks - The Ohio State UniversityEric Mou - University of IowaJonas Paludo - Mayo ClinicGrzegorz S. Nowakowski - Mayo ClinicThomas M. Habermann - Mayo ClinicMatthew J. Maurer - Mayo ClinicDiego Villa - University of British ColumbiaJonathon B. Cohen - Emory UniversityTarec C. El-Galaly - Aarhus University HospitalMats Jerkeman - Lund UniversityJames R. Cerhan - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Blood cancer journal (New York)
- DOI
- 10.1038/s41408-026-01625-5
- ISSN
- 2044-5385
- eISSN
- 2044-5385
- Publisher
- Springer Nature
- Language
- English
- Electronic publication date
- 09/22/2026
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9985236418902771
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