Conditional survival of younger patients with mantle cell lymphoma: Results from a randomized phase III trial of the European MCL Network.

Autor: Jiang L; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany., Dreyling M; Department of Internal Medicine III, LMU University Hospital Munich, Munich, Germany., Hermine O; Department Hematology, Hôpital Necker, Assistance Publique Hôpitaux de Paris, University Paris Descartes, Paris, France., Mansmann U; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany., Walewski J; Department of Lymphoid Malignancies, The Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland., Ribrag V; Institut Gustave Roussy, Villejuif, France., Thieblemont C; Assistance Publique-Hôpitaux de Paris, Hemato-Oncologie, Hôpital Saint Louis, University of Paris, Paris, France., Pott C; Second Medical Department, University Hospital Schleswig-Holstein, Kiel, Germany., Bachy E; Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Université Claude Bernard, Pierre Bénite, France., Feugier P; Service d'Hematologie, Vandoevre les Nancy, France., Hübel K; Klinik I für Innere Medizin, Universität zu Köln, Köln, Germany., Schumacher M; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Hoster E; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Oct 23. Date of Electronic Publication: 2024 Oct 23.
DOI: 10.1111/bjh.19854
Abstrakt: During a fatal disease, patients often request updated information on their prognosis. After patients have already survived a certain time, conditional survival captures their future survival probability. We investigated conditional overall and failure-free survival in 473 younger mantle cell lymphoma (MCL) patients from a randomized phase III trial comparing immunochemotherapies R-CHOP and alternating R-CHOP/R-DHAP before autologous transplantation. Using conditional Kaplan-Meier method and Cox regression, we estimated subsequent survival of patients who had survived 1-8 years, considering MIPI, Ki-67, and treatment failure status. Starting at a lower level, R-CHOP patients only showed increasing subsequent survival as they survived longer (5-year conditional survival: 72% and 81% after surviving 1 and 7 years), while R-CHOP/R-DHAP patients had stable future survival over time (77% and 78%). The prognostic value of MIPI diminished after 3 years in R-CHOP patients but remained unchanged after R-CHOP/R-DHAP. Patients with treatment failure had markedly inferior survival compared with those in ongoing remission, regardless of the time survived. The longer patients remained in remission, the longer they would stay free of treatment failures. Our results enable personalized counselling for younger MCL patients by offering dynamic prognosis and underscore the importance of highly effective first-line treatment to improve survival.
(© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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