Long-term clinical and molecular remissions in patients with mantle cell lymphoma following high-dose therapy and autologous stem cell transplantation.

Abstract

Long-term clinical and molecular remissions in patients with mantle cell lymphoma (MCL) following high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) have been evaluated in only a few studies. Thirty-six patients with MCL received ASCT in our institution (27 patients undergoing first-line therapy, 8 patients undergoing second-line therapy, and 1 patient undergoing third-line therapy). In the case of long-term remission (≥5 years; n = 8), peripheral blood was tested for minimal residual disease (MRD) by t(11; 14) polymerase chain reaction (PCR) and immunoglobulin heavy-chain (IGH) PCR at the last follow-up. Ten-year overall survival (OS), progression-free survival (PFS), and freedom from progression (FFP) after first-line ASCT were 42 %, 43 %, and 54 %; after second-line ASCT, these were all 0 %. Four-year OS, PFS, and FFP for the first-line cohort were 75 %, 48 %, and 61 %, respectively. Four-year OS, PFS, and FFP after second-line ASCT were 55 %, 30 %, and 30 %, respectively. Treatment-related mortality (3 months after ASCT) was 0 %. The only prognostic factor for OS, PFS, and FFP was treatment line (p = 0.011, p = 0.046, and p = 0.023, respectively). No relapses occurred after 5 years following ASCT. So far, eight patients developed sustained long-term clinical and molecular complete remissions of up to 14.6 years following ASCT in the first treatment line. Sustained long-term clinical and molecular remissions can be achieved following ASCT in the first treatment line and apparently less frequent in the second treatment line.

• Authors: Bernd Metzner, Thomas H Müller, Wolfgang Gebauer, Jochen Casper, Doris Kraemer, Bernd Rosien, Silke Schumann-Binarsch, Ruth Thole, Claus H Köhne, Martin Dreyling, Eva Hoster, Christiane Pott
• Journal: Annals of hematology (Ann Hematol) Vol. 93 Issue 5 Pg. 803-10 (May 2014) ISSN: 1432-0584 [Electronic] Germany
• PMID: 24337447 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Antineoplastic Agents
• Immunoglobulin Heavy Chains

Topics

• Adolescent
• Aged
• Antineoplastic Agents (therapeutic use)
• Drug Administration Schedule
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Immunoglobulin Heavy Chains (blood)
• Lymphoma, Mantle-Cell (blood, mortality, pathology, therapy)
• Male
• Middle Aged
• Neoplasm, Residual (blood, mortality, pathology, therapy)
• Prognosis
• Remission Induction
• Survival Analysis
• Transplantation, Autologous
• Treatment Outcome