Nordic MCL2 trial update: six-year follow-up after intensive immunochemotherapy for untreated mantle cell lymphoma followed by BEAM or BEAC + autologous stem-cell support: still very long survival but late relapses do occur.

Abstract

Mantle cell lymphoma (MCL) is a heterogenic non-Hodgkin lymphoma entity, with a median survival of about 5 years. In 2008 we reported the early - based on the median observation time of 4 years - results of the Nordic Lymphoma Group MCL2 study of frontline intensive induction immunochemotherapy and autologous stem cell transplantation (ASCT), with more than 60% event-free survival at 5 years, and no subsequent relapses reported. Here we present an update after a median observation time of 6·5 years. The overall results are still excellent, with median overall survival and response duration longer than 10 years, and a median event-free survival of 7·4 years. However, six patients have now progressed later than 5 years after end of treatment. The international MCL Prognostic Index (MIPI) and Ki-67-expression were the only independent prognostic factors. Subdivided by the MIPI-Biological Index (MIPI + Ki-67, MIPI-B), more than 70% of patients with low-intermediate MIPI-B were alive at 10 years, but only 23% of the patients with high MIPI-B. These results, although highly encouraging regarding the majority of the patients, underline the need of a risk-adapted treatment strategy for MCL. The study was registered at www.isrctn.org as ISRCTN 87866680.

• Authors: Christian H Geisler, Arne Kolstad, Anna Laurell, Mats Jerkeman, Riikka Räty, Niels S Andersen, Lone B Pedersen, Mikael Eriksson, Marie Nordström, Eva Kimby, Hans Bentzen, Outi Kuittinen, Grete F Lauritzsen, Herman Nilsson-Ehle, Elisabeth Ralfkiaer, Mats Ehinger, Christer Sundström, Jan Delabie, Marja-Liisa Karjalainen-Lindsberg, Peter Brown, Erkki Elonen, Nordic Lymphoma Group
• Journal: British journal of haematology (Br J Haematol) Vol. 158 Issue 3 Pg. 355-62 (Aug 2012) ISSN: 1365-2141 [Electronic] England
• PMID: 22640180 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 Blackwell Publishing Ltd.

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Cytarabine
• Rituximab
• Etoposide
• Cyclophosphamide
• Podophyllotoxin
• Melphalan
• Carmustine

Topics

• Aged
• Antibodies, Monoclonal, Murine-Derived (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Carmustine (administration & dosage)
• Cyclophosphamide (administration & dosage)
• Cytarabine (administration & dosage)
• Disease-Free Survival
• Etoposide (administration & dosage)
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Immunotherapy
• Lymphoma, Mantle-Cell (drug therapy, immunology, pathology, therapy)
• Male
• Melphalan (administration & dosage)
• Middle Aged
• Podophyllotoxin (administration & dosage)
• Prognosis
• Recurrence
• Rituximab
• Survival Rate
• Transplantation, Autologous