A multicenter retrospective comparison of induction chemoimmunotherapy regimens on outcomes in transplant-eligible patients with previously untreated mantle cell lymphoma.
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Carmustine
/ therapeutic use
Cytarabine
/ therapeutic use
Disease Progression
Disease-Free Survival
Etoposide
/ therapeutic use
Female
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Immunotherapy
/ methods
Induction Chemotherapy
/ methods
International Cooperation
Lymphoma, Mantle-Cell
/ mortality
Male
Melphalan
/ therapeutic use
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
/ drug therapy
Remission Induction
Retrospective Studies
Transplantation Conditioning
Treatment Outcome
autologous stem cell transplant
conditioning
induction
mantle cell lymphoma
Journal
Hematological oncology
ISSN: 1099-1069
Titre abrégé: Hematol Oncol
Pays: England
ID NLM: 8307268
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
18
03
2019
accepted:
11
04
2019
pubmed:
16
4
2019
medline:
10
9
2019
entrez:
16
4
2019
Statut:
ppublish
Résumé
Mantle cell lymphoma (MCL) is an uncommon and typically aggressive form of lymphoma. Although often initially chemosensitive, relapse is common. Several induction and conditioning regimens are used in transplant-eligible patients, and the optimal approach remains unknown. We performed an international, retrospective study of transplant-eligible patients to assess impact of induction chemoimmunotherapy and conditioning regimens on clinical outcomes. We identified 228 patients meeting inclusion criteria. Baseline characteristics were similar among the induction groups except for some variation in age. The type of induction chemoimmunotherapy received did not influence overall response rates (ORRs) (0.43), progression-free survival (PFS) (P > .67), or overall survival (OS) (P > .35) on multivariate analysis (PFS and OS). Delivery of autologous stem cell transplant (ASCT) was associated with favorable PFS and OS (0.01) on univariate analysis only; this benefit was not seen on multivariate analysis-PFS (0.36) and OS (0.21). Compared with busulfan and melphalan (BuMel), the use of the carmustine, etoposide, cytarabine, melphalan (BEAM)-conditioning regimen was associated with inferior PFS (HR = 2.0 [95% CI 1.1-3.6], 0.02) but not OS (HR = 1.1 [95% CI 0.5-2.3], 0.81) on univariate analysis only. Within the limits of a retrospective study and modest power for some comparisons, type of induction therapy did not influence ORR, PFS, or OS for transplant-eligible patients with MCL. International efforts are required to perform randomized clinical trials evaluating chemoimmunotherapy induction regimens.
Substances chimiques
Cytarabine
04079A1RDZ
Etoposide
6PLQ3CP4P3
Melphalan
Q41OR9510P
Carmustine
U68WG3173Y
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
253-260Informations de copyright
© 2019 John Wiley & Sons, Ltd.
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