TY - JOUR
T1 - Outcomes in first relapsed-refractory younger patients with mantle cell lymphoma
T2 - results from the MANTLE-FIRST study
AU - Visco, Carlo
AU - Di Rocco, Alice
AU - Evangelista, Andrea
AU - Quaglia, Francesca Maria
AU - Tisi, Maria Chiara
AU - Morello, Lucia
AU - Zilioli, Vittorio Ruggero
AU - Rusconi, Chiara
AU - Hohaus, Stefan
AU - Sciarra, Roberta
AU - Re, Alessandro
AU - Tecchio, Cristina
AU - Chiappella, Annalisa
AU - Marin-Niebla, Ana
AU - McCulloch, Rory
AU - Gini, Guido
AU - Perrone, Tommasina
AU - Nassi, Luca
AU - Pennese, Elsa
AU - Stefani, Piero Maria
AU - Cox, Maria Christina
AU - Bozzoli, Valentina
AU - Fabbri, Alberto
AU - Polli, Valentina
AU - Ferrero, Simone
AU - Celis, Maria Isabel Alvarez De
AU - Sica, Antonello
AU - Petrucci, Luca
AU - Arcaini, Luca
AU - Rule, Simon
AU - Krampera, Mauro
AU - Vitolo, Umberto
AU - Balzarotti, Monica
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85089286846
U2 - 10.1038/s41375-020-01013-3
DO - 10.1038/s41375-020-01013-3
M3 - Article
C2 - 32782382
AN - SCOPUS:85089286846
SN - 0887-6924
VL - 35
SP - 787
EP - 795
JO - Leukemia
JF - Leukemia
IS - 3
ER -
