A multicenter retrospective comparison of induction chemoimmunotherapy regimens on outcomes in transplant-eligible patients with previously untreated mantle cell lymphoma

Autor: John F. Seymour, Niles Nelson, Tara Cochrane, Chan Yoon Cheah, Sanjay De Mel Widanalage, Hui Peng Lee, Melissa Liet Hing Ng, Eliza A Hawkes, Greg Hapgood, Anna Johnston, Sophie Shorten, Sumita Ratnasingam, Liu Xin, Robert M. Campbell, Constantine S. Tam, Kate Manos, Tenny Sunny, Michelle Poon, David Ritchie, Anthony P. Schwarer, Duncan Purtill, Mark Bishton, Stephen Opat, Zi Yun Ng, Kate Hill, Michael Gilbertson
Rok vydání: 2019
Předmět:
Oncology
Melphalan
Adult
Male
Cancer Research
medicine.medical_specialty
Transplantation Conditioning
International Cooperation
Lymphoma
Mantle-Cell
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Chemoimmunotherapy
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Etoposide
Aged
Retrospective Studies
Univariate analysis
business.industry
Remission Induction
Cytarabine
Hematopoietic Stem Cell Transplantation
Induction chemotherapy
Hematology
General Medicine
Induction Chemotherapy
Middle Aged
medicine.disease
Carmustine
Regimen
Treatment Outcome
030220 oncology & carcinogenesis
Multivariate Analysis
Disease Progression
Mantle cell lymphoma
Rituximab
Female
Immunotherapy
Neoplasm Recurrence
Local
business
030215 immunology
medicine.drug
Zdroj: Hematological oncologyREFERENCES. 37(3)
ISSN: 1099-1069
Popis: Mantle cell lymphoma (MCL) is an uncommon and typically aggressive form of lymphoma. Although often initially chemosensitive, relapse is common. Several induction and conditioning regimens are used in transplant-eligible patients, and the optimal approach remains unknown. We performed an international, retrospective study of transplant-eligible patients to assess impact of induction chemoimmunotherapy and conditioning regimens on clinical outcomes. We identified 228 patients meeting inclusion criteria. Baseline characteristics were similar among the induction groups except for some variation in age. The type of induction chemoimmunotherapy received did not influence overall response rates (ORRs) (0.43), progression-free survival (PFS) (P > .67), or overall survival (OS) (P > .35) on multivariate analysis (PFS and OS). Delivery of autologous stem cell transplant (ASCT) was associated with favorable PFS and OS (0.01) on univariate analysis only; this benefit was not seen on multivariate analysis-PFS (0.36) and OS (0.21). Compared with busulfan and melphalan (BuMel), the use of the carmustine, etoposide, cytarabine, melphalan (BEAM)-conditioning regimen was associated with inferior PFS (HR = 2.0 [95% CI 1.1-3.6], 0.02) but not OS (HR = 1.1 [95% CI 0.5-2.3], 0.81) on univariate analysis only. Within the limits of a retrospective study and modest power for some comparisons, type of induction therapy did not influence ORR, PFS, or OS for transplant-eligible patients with MCL. International efforts are required to perform randomized clinical trials evaluating chemoimmunotherapy induction regimens.
Databáze: OpenAIRE
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