Upfront Management of Blastoid Variant Mantle Cell Lymphoma: Making the Case for 2nd/3rd-Generation Bruton Tyrosine Kinase Inhibitor-Based Therapies.

Autor: Lee BJ; Department of Pharmacy, University of California Irvine Health, Orange, California, USA.; Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, California, USA., Liu J; Department of Pharmacy, University of California Irvine Health, Orange, California, USA., Griffin SP; Department of Pharmacy, University of California Irvine Health, Orange, California, USA.; Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, California, USA., Doh J; Department of Pharmacy, University of California Irvine Health, Orange, California, USA.; Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, California, USA., Ciurea SO; Department of Medicine, Division of Hematology Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA., Kongtim P; Department of Medicine, Division of Hematology Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA., Brem EA; Department of Medicine, Division of Hematology Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 Oct; Vol. 13 (19), pp. e70310.
DOI: 10.1002/cam4.70310
Abstrakt: Introduction: Blastoid variant-mantle cell lymphoma (BV-MCL) represents an aggressive subset of patients with no established standard of care treatment approach.
Methods: We performed a retrospective analysis of the clinical characteristics and outcomes of 17 de novo BV-MCL patients treated at our institution between May 2009 and September 2023. In addition, we reviewed the literature supporting 2nd/3rd generation Bruton's Tyrosine-kinase (BTKi)-based therapies for upfront management.
Results: The complete response rate to frontline and salvage therapy was 66.7% and 25%, respectively. Two-year overall survival (OS) was low at 62.5% (95% CI, 34.7%-81.1%). Variables associated with higher OS included receipt of consolidative HSCT (p = 0.017), TP53-wild type (p = 0.031), intermediate- versus high-risk Mantle Cell Lymphoma Prognostic Index score (p = 0.026), and achieving complete response with induction therapy (p = 0.027).
Discussion: Treatment outcomes with chemo-immunotherapy in BV-MCL patients are poor, especially among TP53-mutated patients. Recent findings describing positive outcomes with novel BTKi-based therapies are encouraging and should be considered in this high-risk population.
(© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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