Outcomes in first relapsed-refractory younger patients with mantle cell lymphoma: results from the MANTLE-FIRST study.
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Drug Resistance, Neoplasm
Female
Follow-Up Studies
Humans
International Agencies
Lymphoma, Mantle-Cell
/ drug therapy
Male
Middle Aged
Neoplasm Recurrence, Local
/ drug therapy
Prognosis
Retrospective Studies
Salvage Therapy
Survival Rate
Young Adult
Journal
Leukemia
ISSN: 1476-5551
Titre abrégé: Leukemia
Pays: England
ID NLM: 8704895
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
02
04
2020
accepted:
30
07
2020
revised:
23
07
2020
pubmed:
13
8
2020
medline:
23
3
2021
entrez:
13
8
2020
Statut:
ppublish
Résumé
Patients with mantle cell lymphoma (MCL) that fail induction treatment represent a difficult-to-treat population, where no standard therapy exists. We evaluated outcomes in patients with first relapsed-refractory (r/r) MCL after upfront high dose cytarabine including standard regimens. Overall survival (OS-2) and progression-free survival (PFS-2) were estimated from the time of salvage therapy. The previously described threshold of 24 months was used to define patients as early- or late-progressors (POD). Overall, 261 r/r MCL patients were included. Second-line regimens consisted of rituximab-bendamustine (R-B, 21%), R-B and cytarabine (R-BAC, 29%), ibrutinib (19%), and others (31%). The four groups were balanced in terms of clinicopathological features. Adjusting for age and early/late-POD, patients treated with R-BAC had significantly higher complete remission (63%) than comparators. Overall, Ibrutinib and R-BAC were associated with improved median PFS-2 [24 and 25 months, respectively], compared to R-B (13) or others (7). In patients with early-POD (n = 127), ibrutinib was associated with inferior risk of death than comparators (HR 2.41 for R-B, 2.17 for others, 2.78 for R-BAC). In patients with late-POD (n = 134), no significant differences were observed between ibrutinib and bendamustine-based treatments. Ibrutinib was associated with improved outcome in early-POD patients.
Identifiants
pubmed: 32782382
doi: 10.1038/s41375-020-01013-3
pii: 10.1038/s41375-020-01013-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
787-795Commentaires et corrections
Type : ErratumIn
Références
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