Comparative outcome of initial therapy for younger patients with mantle cell lymphoma: an analysis from the NCCN NHL Database

被引：79

作者：

LaCasce, Ann S. ^{[1
]}

Vandergrift, Jonathan L. ^{[2
]}

Rodriguez, Maria A. ^{[3
]}

Abel, Gregory A. ^{[1
]}

Crosby, Allison L. ^{[1
]}

Czuczman, Myron S. ^{[4
]}

Nademanee, Auayporn P. ^{[5
]}

Blayney, Douglas W. ^{[6
]}

Gordon, Leo I. ^{[7
]}

Millenson, Michael ^{[8
]}

Vanderplas, Ann ^{[5
]}

Lepisto, Eva M. ^{[2
]}

Zelenetz, Andrew D. ^{[9
]}

Niland, Joyce ^{[5
]}

Friedberg, Jonathan W. ^{[10
]}

机构：

[1] Dana Farber Canc Inst, Boston, MA 02115 USA

[2] Natl Comprehens Canc Network, Ft Washington, MD USA

[3] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA

[4] Roswell Pk Canc Inst, Buffalo, NY 14263 USA

[5] City Hope Natl Med Ctr, Duarte, CA 91010 USA

[6] Stanford Canc Ctr, Stanford, CA USA

[7] Northwestern Univ, Dept Med, Feinberg Sch Med, Div Hematol Oncol, Chicago, IL 60611 USA

[8] Fox Chase Canc Ctr, Philadelphia, PA 19111 USA

[9] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA

[10] Univ Rochester, James P Wilmot Canc Ctr, Rochester, NY USA

来源：

BLOOD | 2012年 / 119卷 / 09期

关键词：

INTERNATIONAL PROGNOSTIC INDEX; PROSPECTIVE RANDOMIZED-TRIAL; PROGRESSION-FREE SURVIVAL; IMMUNOCHEMOTHERAPY; RITUXIMAB; TRANSPLANTATION; MULTICENTER; SUPERIOR; NETWORK; MIPI;

D O I：

10.1182/blood-2011-07-369629

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Few randomized trials have compared therapies in mantle cell lymphoma (MCL), and the role of aggressive induction is unclear. The National Comprehensive Cancer Network (NCCN) Non-Hodgkin Lymphoma (NHL) Database, a prospective cohort study collecting clinical, treatment, and outcome data at 7 NCCN centers, provides a unique opportunity to compare the effectiveness of initial therapies in MCL. Patients younger than 65 diagnosed between 2000 and 2008 were included if they received RHCVAD (rituximab fractionated cyclophosphamide, vincristine, adriamycin, and dexamethasone), RCHOP+HDT/ASCR (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone + high-dose therapy/autologous stem cell rescue), RHCVAD+HDT/ASCR, or RCHOP. Clinical parameters were similar for patients treated with RHCVAD (n = 83, 50%), RCHOP+HDT/ASCR (n = 34, 20%), RCHOP (n = 29, 17%), or RHCVAD+HDT/ASCR (n = 21, 13%). Overall, 70 (42%) of the 167 patients progressed and 25 (15%) expired with a median follow-up of 33 months. There was no difference in progression-free survival (PFS) between aggressive regimens (P > .57), which all demonstrated superior PFS compared with RCHOP (P < .004). There was no difference in overall survival (OS) between the RHCVAD and RCHOP+HDT/ASCR (P = .98). RCHOP was inferior to RHCVAD and RCHOP+HDT/ASCR, which had similar PFS and OS. Despite aggressive regimens, the median PFS was 3 to 4 years. Future trials should focus on novel agents rather than comparing current approaches. (Blood. 2012; 119(9): 2093-2099)

引用

页码：2093 / 2099

页数：7

共 23 条

[1] Mantle Cell Lymphoma International Prognostic Index but Not Pretransplantation Induction Regimen Predicts Survival for Patients With Mantle-Cell Lymphoma Receiving High-Dose Therapy and Autologous Stem-Cell Transplantation [J].

Budde, Lihua E. ;

Guthrie, Katherine A. ;

Till, Brian G. ;

Press, Oliver W. ;

Chauncey, Thomas R. ;

Pagel, John M. ;

Petersdorf, Steven H. ;

Bensinger, William I. ;

Holmberg, Leona A. ;

Shustov, Andrei R. ;

Green, Damian J. ;

Maloney, David G. ;

Gopal, Ajay K. .

JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (22) :3023-3029

[2] A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].

CHARLSON, ME ;

POMPEI, P ;

ALES, KL ;

MACKENZIE, CR .

JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383

[3] Immunochemotherapy and Autologous Stem-Cell Transplantation for Untreated Patients With Mantle-Cell Lymphoma: CALGB 59909 [J].

Damon, Lloyd E. ;

Johnson, Jeffrey L. ;

Niedzwiecki, Donna ;

Cheson, Bruce D. ;

Hurd, David D. ;

Bartlett, Nancy L. ;

LaCasce, Ann S. ;

Blum, Kristie A. ;

Byrd, John C. ;

Kelly, Michael ;

Stock, Wendy ;

Linker, Charles A. ;

Canellos, George P. .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (36) :6101-6108

[4] Ki-67 predicts outcome in advanced-stage mantle cell lymphoma patients treated with anti-CD20 immunochemotherapy: results from randomized trials of the European MCL Network and the German Low Grade lymphoma Study Group [J].

Determann, Olaf ;

Hoster, Eva ;

Ott, German ;

Bernd, Heinz Wolfram ;

Loddenkemper, Christoph ;

Hansmann, Martin Leo ;

Barth, Thomas E. F. ;

Unterhalt, Michael ;

Hiddemann, Wolfgang ;

Dreyling, Martin ;

Klapper, Wolfram .

BLOOD, 2008, 111 (04) :2385-2387

[5] Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network [J].

Dreyling, M ;

Lenz, G ;

Hoster, E ;

Van Hoof, A ;

Gisselbrecht, C ;

Schmits, R ;

Metzner, B ;

Truemper, L ;

Reiser, M ;

Steinhauer, H ;

Boiron, JM ;

Boogaerts, MA ;

Aldaoud, A ;

Silingardi, V ;

Kluin-Nelemans, HC ;

Hasford, J ;

Parwaresch, R ;

Unterhalt, M ;

Hiddemann, W .

BLOOD, 2005, 105 (07) :2677-2684

[6]

Epner EM, 2007, BLOOD, V110, p121A

[7]

FDA, 2018, CLIN TRIAL ENDP APPR

[8] Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue:: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group [J].

Geisler, Christian H. ;

Kolstad, Arne ;

Laurell, Anna ;

Andersen, Niels S. ;

Pedersen, Lone B. ;

Jerkeman, Mats ;

Eriksson, Mikael ;

Nordstrom, Marie ;

Kimby, Eva ;

Boesen, Anne Marie ;

Kuittinen, Outi ;

Lauritzsen, Grete F. ;

Nilsson-Ehle, Herman ;

Ralfkiaer, Elisabeth ;

Akerman, Mans ;

Ehinger, Mats ;

Sundstrom, Christer ;

Langholm, Ruth ;

Delabie, Jan ;

Karjalainen-Lindsberg, Marja-Liisa ;

Brown, Peter ;

Elonen, Erkki .

BLOOD, 2008, 112 (07) :2687-2693

[9] The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT) [J].