Death from mantle cell lymphoma limits sequential therapy, particularly after first relapse: Patterns of care and outcomes in a series from Australia and the United Kingdom.

Autor: Minson A; Peter MacCallum Cancer Centre & Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia., Hamad N; St Vincent's Hospital, Sydney, New South Wales, Australia., Di Ciaccio P; Canberra Hospital, Canberra, Australian Capital Territory, Australia., Talaulikar D; Canberra Hospital, Canberra, Australian Capital Territory, Australia., Ku M; St Vincent's Hospital, Melbourne, Victoria, Australia., Ratnasingam S; Barwon Health, Geelong, Victoria, Australia., Cheah C; Sir Charles Gairdner Hospital & Linear Health, Perth, Western Australia, Australia., Yannakou CK; Epworth HealthCare, Melbourne, Victoria, Australia., Bishton M; Nottingham University Hospital, Nottingham, UK., Ng ZY; Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia., Agrawal S; Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia., McQuillan A; Hollywood Private Hospital, Perth, Western Australia, Australia., Johnston A; Royal Hobart Hospital, Hobart, Tasmania, Australia., Choong E; Royal Hobart Hospital, Hobart, Tasmania, Australia., Wong K; Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia., McQuillan J; Hollywood Private Hospital, Perth, Western Australia, Australia., Beekman A; Barwon Health, Geelong, Victoria, Australia., Hawkes E; Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Dickinson M; Peter MacCallum Cancer Centre & Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Feb; Vol. 204 (2), pp. 548-554. Date of Electronic Publication: 2023 Oct 30.
DOI: 10.1111/bjh.19179
Abstrakt: Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T-cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma-related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10-year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second-line treatment. This limitation of sequential treatment by lymphoma-related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high-risk patient populations.
(© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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