scholarly journals Treatment patterns and outcomes of older patients with mantle cell lymphoma in an Asian population

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyi Yang ◽  
Lay Poh Khoo ◽  
Esther Wei Yin Chang ◽  
Valerie Shiwen Yang ◽  
Eileen Poon ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Induction Chemotherapy ◽  
Older Patients ◽  
Cell Lymphoma ◽  
Asian Population ◽  
Treatment Patterns ◽  
Older Age ◽  
Younger Patients ◽  
Mantle Cell ◽  
The Impact

Abstract Background Significant progress has been made in the treatment outcomes of mantle cell lymphoma (MCL) since the introduction of cytarabine and rituximab in modern regimens. However, older patients may not readily tolerate these agents nor derive benefit. We investigated the impact of age on treatment patterns and clinical outcomes of MCL patients in an Asian population. Methods A retrospective study was conducted on patients (n = 66) diagnosed with MCL at the National Cancer Centre Singapore between 1998 and 2018. The median follow-up duration was 40 months. Survival analyses were performed using the Kaplan-Meier method and multivariate Cox proportional models. Results The median age of the cohort was 59 years (range, 26–84), with a male predominance (73%). The majority (86%) had advanced stage 3–4 disease at diagnosis. Compared with younger patients, older patients aged ≥60 years (n = 32; 48.5%) presented more frequently with B-symptoms (75% vs 38%, p = 0.0028), anaemia (75% vs 35%, p = 0.0013), and carried higher prognostic risk scores (sMIPI high risk 84% vs 56%, p = 0.016). Non-cytarabine-based induction chemotherapy was more commonly administered in older patients (76% vs 32%, p = 0.0012). The 5-year overall survival (OS) and progression-free survival (PFS) was 68 and 25% respectively. In a multivariable model, older age (HR 3.42, 95%CI 1.48–7.92, p = 0.004) and anemia (HR 2.56, 95%CI 1.10–5.96, p = 0.029) were independently associated with poorer OS while older age (HR 2.24, 95%CI 1.21–4.14, p = 0.010) and hypoalbuminemia (HR 2.20, 95%CI 1.17–4.13, p = 0.014) were independently associated with poorer PFS. In an exploratory analysis, maintenance rituximab following induction chemotherapy improved PFS in younger patients, with median PFS of 131 months and 45 months with or without maintenance therapy respectively (HR 0.39, 95%CI 0.16–0.93, p = 0.035). In contrast, no survival benefit was observed in older patients. Conclusions We demonstrated in our analysis that older patients with MCL may harbor adverse clinical features and may not derive benefit from maintenance rituximab, highlighting the need for further research in this area of need.

scholarly journals 259O Treatment patterns and outcomes in older patients with mantle cell lymphoma in an Asian population

2020 ◽  
Vol 31 ◽  
pp. S1344
Author(s):  
X. Yang ◽  
L.P. Khoo ◽  
E.W.Y. Chang ◽  
V.S. Yang ◽  
E.Y.L. Poon ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Older Patients ◽  
Cell Lymphoma ◽  
Asian Population ◽  
Treatment Patterns ◽  
Mantle Cell

scholarly journals TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy

Blood ◽  
2017 ◽  
Vol 130 (17) ◽  
pp. 1903-1910 ◽  
Author(s):  
Christian W. Eskelund ◽  
Christina Dahl ◽  
Jakob W. Hansen ◽  
Maj Westman ◽  
Arne Kolstad ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Standard Of Care ◽  
Younger Patients ◽  
Tp53 Mutations ◽  
Key Points ◽  
Mantle Cell ◽  
Frontline Treatment

Key Points The intensified standard-of-care regimens for younger patients with MCL do not overcome the deleterious effects of TP53 mutations. MCLs with TP53 mutations should be considered for alternative frontline treatment.

scholarly journals VcR-CVAD Induction Chemotherapy Followed by Maintenance Rituximab Produces Durable Remissions in Mantle Cell Lymphoma: A Wisconsin Oncology Network Study

2018 ◽  
Vol 18 (1) ◽  
pp. e61-e67 ◽  
Author(s):  
Julie E. Chang ◽  
Lakeesha L. Carmichael ◽  
KyungMann Kim ◽  
Christopher Peterson ◽  
David T. Yang ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Induction Chemotherapy ◽  
Cell Lymphoma ◽  
Mantle Cell

scholarly journals Survival Outcomes of Younger Patients With Mantle Cell Lymphoma Treated in the Rituximab Era

2019 ◽  
Vol 37 (6) ◽  
pp. 471-480 ◽  
Author(s):  
James N. Gerson ◽  
Elizabeth Handorf ◽  
Diego Villa ◽  
Alina S. Gerrie ◽  
Parv Chapani ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Mantle Cell Lymphoma ◽  
Hematopoietic Cell Transplantation ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large Cohort ◽  
Multivariable Regression Analysis ◽  
Mantle Cell ◽  
Multivariable Regression ◽  
The Impact

PURPOSE Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger. PATIENTS AND METHODS We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score–weighted (PSW) analysis were performed. RESULTS Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2). CONCLUSION In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.

Rituximab maintenance improves progression-free and overall survival rates after combined immuno-chemotherapy (R-FCM) in patients with relapsed follicular and mantle cell lymphoma: Final results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7502-7502 ◽  
Author(s):  
M. Dreyling ◽  
R. Forstpointner ◽  
M. Gramatzki ◽  
H. Böck ◽  
M. Hänel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Remission Induction ◽  
Low Grade ◽  
Free Survival ◽  
Mantle Cell ◽  
The Impact

7502 Background: Rituximab (R) prolongs the progression-free survival (PFS) in patients with follicular lymphoma (FL) when given either simultaneously with or as maintenance after chemotherapy only. Methods: In the current study the impact of R maintenance after remission induction with an R-containing combined immuno-chemotherapy (R-FCM) was evaluated. Patients with advanced stage relapsed or refractory FL and mantle cell lymphoma (MCL) were eligible. The study design comprized 4 courses of chemotherapy with Fludarabine (25 mg/m2/d days 1–3), Cyclophosphamide (200 mg/m2/d days 1–3) and Mitoxantrone (8 mg/m2/d day 1) (FCM) ± Rituximab (375 mg/m2/d day 0). Patients entering a complete (CR) or partial remission (PR) underwent a second randomization for R maintenance (4 weekly doses (375 mg/m2/d) at three and nine months after end of induction) or observation only. Randomization was stratified for histology, prior therapies (up to 2 lines vs. >2), induction (±R), and response (CR vs. PR). After improved outcome of the R-FCM arm had been observed in the initial 147 randomized patients, all subsequent patients received a combined immuno-chemotherapy induction. Results: 176 of 195 randomized cases are evaluable, 138 of whom had received an R-containing induction. In these patients (as well as the total group) the median PFS after end of induction has not been reached in the R-maintenance arm in contrast to 17 months in patients with no further treatment (p = 0.001). This improvement was seen both in FL (n = 81; p = 0,035) and MCL (n = 47; p = 0,049). More importantly, overall survival rate was also improved after R maintenance with borderline significance (3 y rate 82% vs. 55%; p = 0,056). No major sided effects of R maintenance have been observed and the rate of serious infections was similar in both study arms (p = 0.72). Conclusions: The final analysis of this study confirms that R maintenance after combined immuno-chemotherapy (R-FCM) is highly effective and improves the progression-free survival—with a strong trend towards improved overall survival—of patients with relapsed FL and MCL. [Table: see text]

Impact of rituximab on outcome of autologous transplantation for mantle cell lymphoma

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7555-7555 ◽  
Author(s):  
A. Naing ◽  
J. Palmer ◽  
N. Tsai ◽  
N. Kogut ◽  
L. Popplewell ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Median Survival ◽  
Relapse Rate ◽  
Survival Probability ◽  
Cell Lymphoma ◽  
Disease Stage ◽  
Bulky Disease ◽  
Mantle Cell ◽  
The Impact ◽  
Disease Free

7555 Background: Currently, Mantle Cell Lymphoma (MCL) is an incurable disease. Patients treated with chemotherapy alone experience only transient responses, with no long-term improvement in disease-free/overall survival. While autologous hematopoietic stem cell transplantation (ASCT) in MCL patients has demonstrated prolonged survival, relapse remains the major issue. We evaluate the impact of rituximab (Rituxan, Rtx) on relapse and survival following ASCT. Method: A case-series of 83 MCL patients treated with ASCT at City of Hope (from 02/1991 to 04/2005) were examined; a total of 52 patients received Rtx (with-Rtx) as part of their induction/salvage treatment (pre-ASCT) and/or maintenance therapy (post-ASCT), 31 patients did not receive Rtx (no-Rtx) at any point pre-/post-ASCT. An assessment of baseline patient and disease characteristics (gender, age, KPS, % of pts with bone marrow involvement at diagnosis, disease stage/status at ASCT, % of pts with bulky disease B-symptoms at ASCT, and # of regimens administered prior to ASCT) showed no significant differences among the two groups. Result: To date, 23 patients have relapsed/progressed post-ASCT; 61% of the patients in the no-Rtx group remain disease free at last contact, while 79% in the with-Rtx group remain disease free. The median survival in the no-Rtx group is 77.63 months; the median survival time point for the with-Rtx group has not been reached due to shorter follow-up period. The 2-yr relapse rate for the with-Rtx/no-Rtx groups among 1st CR/PR patients were 19% (95% CI: 10–33%) and 26% (95% CI: 14–43%) (p > 0.05) respectively and the 2-yr relapse rate for the with-Rtx/no-Rtx groups among the beyond 1st CR pts were 33% and 40% respectively (p > 0.05). The survival endpoint showed similar results. The 2-yr survival probability for the with-Rtx/no-Rtx groups among the 1st CR/PR patients were 91% (95% CI: 76–97%) and 82% (95% CI: 64–91%) (p > 0.05) respectively and the 2-yr survival probability for the with-Rtx/no-Rtx groups among the patients beyond 1st CR/PR were 59% and 63% respectively (p > 0.05). Conclusion: Using Rtx as induction/salvage and/or maintenance before and after ASCT therapy may not be associated with decreased relapse and improved survival. Nevertheless, our data indicate that outcome is better when ASCT is carried out at 1st CR/PR. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document