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

被引:76
|
作者
Gerson, James N. [1 ]
Handorf, Elizabeth [1 ]
Villa, Diego [2 ]
Gerrie, Alina S. [2 ]
Chapani, Pary [2 ]
Li, Shaoying [3 ]
Medeiros, L. Jeffrey [3 ]
Wang, Michael, I [3 ]
Cohen, Jonathon B. [4 ]
Calzada, Oscar [4 ]
Churnetski, Michael C. [4 ]
Hill, Brian T. [5 ]
Sawalha, Yazeed [5 ]
Hernandez-Ilizaliturri, Francisco J. [6 ]
Kothari, Shalin [6 ]
Vose, Julie M. [7 ]
Bast, Martin A. [7 ]
Fenske, Timothy S. [8 ]
Gari, Swapna Narayana Rao [8 ]
Maddocks, Kami J. [9 ]
Bond, David [9 ]
Bachanova, Veronika [10 ]
Kolla, Bhaskar [10 ]
Chavez, Julio [11 ]
Shah, Bijal [11 ]
Lansigan, Frederick [12 ]
Burns, Timothy F. [12 ]
Donovan, Alexandra M. [12 ]
Wagner-Johnston, Nina [13 ]
Messmer, Marcus [13 ]
Mehta, Amitkumar [14 ]
Anderson, Jennifer K. [14 ]
Reddy, Nishitha [15 ]
Kovach, Alexandra E. [15 ]
Landsburg, Daniel J. [16 ]
Glenn, Martha [17 ]
Inwards, David J. [18 ]
Karmali, Reem [19 ]
Kaplan, Jason B. [19 ]
Caimi, Paolo F. [20 ]
Rajguru, Saurabh [21 ]
Evens, Andrew [22 ]
Klein, Andreas [22 ]
Umyarova, Elvira [23 ]
Pulluri, Bhargavi [23 ]
Amengual, Jennifer E. [24 ]
Lue, Jennifer K. [24 ]
Diefenbach, Catherine [25 ]
Fisher, Richard, I [1 ]
Barta, Stefan K. [1 ]
机构
[1] Fox Chase Canc Ctr, 7701 Burholme Ave, Philadelphia, PA 19111 USA
[2] BC Canc, Vancouver, BC, Canada
[3] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
[4] Emory Univ, Atlanta, GA 30322 USA
[5] Cleveland Clin Fdn, 9500 Euclid Ave, Cleveland, OH 44195 USA
[6] Roswell Pk Canc Inst, Buffalo, NY 14263 USA
[7] Univ Nebraska, Canc Ctr, Omaha, NE 68182 USA
[8] Med Coll Wisconsin, Milwaukee, WI 53226 USA
[9] Ohio State Univ, Columbus, OH 43210 USA
[10] Univ Minnesota, Minneapolis, MN USA
[11] H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USA
[12] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA
[13] Johns Hopkins Univ, Baltimore, MD USA
[14] Univ Alabama Birmingham, Canc Ctr, Birmingham, AL USA
[15] Vanderbilt Ingram Canc Ctr, Nashville, TN USA
[16] Univ Penn, 3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA
[17] Huntsman Canc Inst, Salt Lake City, UT USA
[18] Mayo Clin, Rochester, MN USA
[19] Northwestern Univ, Evanston, IL USA
[20] Case Western Reserve Univ, Cleveland, OH 44106 USA
[21] Univ Wisconsin, Madison, WI USA
[22] Tufts Univ, Boston, MA 02111 USA
[23] Univ Vermont, Burlington, VT USA
[24] Columbia Univ, New York, NY USA
[25] NYU, New York, NY USA
关键词
PROGRESSION-FREE SURVIVAL; INTERNATIONAL PROGNOSTIC INDEX; RANDOMIZED-TRIALS; TRANSPLANTATION; IMMUNOCHEMOTHERAPY; PATHOGENESIS; MULTICENTER; THERAPY; PATTERN; IMPACT;
D O I
10.1200/JCO.18.00690
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSEMantle 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 METHODSWe 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.RESULTSData 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).CONCLUSIONIn 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.
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页码:471 / +
页数:17
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