Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era

James N. Gerson; Elizabeth Handorf; Diego Villa; Alina S. Gerrie; Parv Chapani; Shaoying Li; L. Jeffrey Medeiros; Michael I. Wang; Jonathon B. Cohen; Oscar Calzada; Michael C. Churnetski; Brian T. Hill; Yazeed Sawalha; Francisco J. Hernandez-Ilizaliturri; Shalin Kothari; Julie M. Vose; Martin A. Bast; Timothy S. Fenske; Swapna Narayana Rao Gari; Kami J. Maddocks; David Bond; Veronika Bachanova; Bhaskar Kolla; Julio Chavez; Bijal Shah; Frederick Lansigan; Timothy F. Burns; Alexandra M. Donovan; Nina Wagner-Johnston; Marcus Messmer; Amitkumar Mehta; Jennifer K. Anderson; Nishitha Reddy; Alexandra E. Kovach; Daniel J. Landsburg; Martha Glenn; David J. Inwards; Reem Karmali; Jason B. Kaplan; Paolo F. Caimi; Saurabh Rajguru; Andrew Evens; Andreas Klein; Elvira Umyarova; Bhargavi Pulluri; Jennifer E. Amengual; Jennifer K. Lue; Catherine Diefenbach; Richard I. Fisher; Stefan K. Barta

doi:10.1200/JCO.18.00690

Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era

James N. Gerson, Elizabeth Handorf, Diego Villa, Alina S. Gerrie, Parv Chapani, Shaoying Li, L. Jeffrey Medeiros, Michael I. Wang, Jonathon B. Cohen, Oscar Calzada, Michael C. Churnetski, Brian T. Hill, Yazeed Sawalha, Francisco J. Hernandez-Ilizaliturri, Shalin Kothari, Julie M. Vose, Martin A. Bast, Timothy S. Fenske, Swapna Narayana Rao Gari, Kami J. MaddocksDavid Bond, Veronika Bachanova, Bhaskar Kolla, Julio Chavez, Bijal Shah, Frederick Lansigan, Timothy F. Burns, Alexandra M. Donovan, Nina Wagner-Johnston, Marcus Messmer, Amitkumar Mehta, Jennifer K. Anderson, Nishitha Reddy, Alexandra E. Kovach, Daniel J. Landsburg, Martha Glenn, David J. Inwards, Reem Karmali, Jason B. Kaplan, Paolo F. Caimi, Saurabh Rajguru, Andrew Evens, Andreas Klein, Elvira Umyarova, Bhargavi Pulluri, Jennifer E. Amengual, Jennifer K. Lue, Catherine Diefenbach, Richard I. Fisher, Stefan K. Barta

Research output: Contribution to journal › Article › peer-review

74 Scopus citations

Abstract

PURPOSE: Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.

PATIENTS AND METHODS: We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score-weighted (PSW) analysis were performed.

RESULTS: Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).

CONCLUSION: In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.

Original language	English (US)
Pages (from-to)	471-480
Number of pages	10
Journal	Journal of Clinical Oncology
Volume	37
Issue number	6
DOIs	https://doi.org/10.1200/JCO.18.00690
State	Published - Feb 20 2019

Bibliographical note

Publisher Copyright:
© 2019 by American Society of Clinical Oncology.

Keywords

Adult
Age Factors
Aged
Antineoplastic Agents, Immunological/adverse effects
Antineoplastic Combined Chemotherapy Protocols/adverse effects
Female
Hematopoietic Stem Cell Transplantation/adverse effects
Humans
Lymphoma, Mantle-Cell/mortality
Male
Middle Aged
North America
Progression-Free Survival
Retrospective Studies
Risk Assessment
Risk Factors
Rituximab/adverse effects
Time Factors
Transplantation, Autologous
Young Adult

PubMed: MeSH publication types

Multicenter Study
Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1200/JCO.18.00690

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Gerson, J. N., Handorf, E., Villa, D., Gerrie, A. S., Chapani, P., Li, S., Jeffrey Medeiros, L., Wang, M. I., Cohen, J. B., Calzada, O., Churnetski, M. C., Hill, B. T., Sawalha, Y., Hernandez-Ilizaliturri, F. J., Kothari, S., Vose, J. M., Bast, M. A., Fenske, T. S., Gari, S. N. R., ... Barta, S. K. (2019). Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era. Journal of Clinical Oncology, 37(6), 471-480. https://doi.org/10.1200/JCO.18.00690

Gerson, JN, Handorf, E, Villa, D, Gerrie, AS, Chapani, P, Li, S, Jeffrey Medeiros, L, Wang, MI, Cohen, JB, Calzada, O, Churnetski, MC, Hill, BT, Sawalha, Y, Hernandez-Ilizaliturri, FJ, Kothari, S, Vose, JM, Bast, MA, Fenske, TS, Gari, SNR, Maddocks, KJ, Bond, D, Bachanova, V , Kolla, B, Chavez, J, Shah, B, Lansigan, F, Burns, TF, Donovan, AM, Wagner-Johnston, N, Messmer, M, Mehta, A, Anderson, JK, Reddy, N, Kovach, AE, Landsburg, DJ, Glenn, M, Inwards, DJ, Karmali, R, Kaplan, JB, Caimi, PF, Rajguru, S, Evens, A, Klein, A, Umyarova, E, Pulluri, B, Amengual, JE, Lue, JK, Diefenbach, C, Fisher, RI & Barta, SK 2019, 'Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era', Journal of Clinical Oncology, vol. 37, no. 6, pp. 471-480. https://doi.org/10.1200/JCO.18.00690

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title = "Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era",

abstract = "PURPOSE: Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.PATIENTS AND METHODS: We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score-weighted (PSW) analysis were performed.RESULTS: Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).CONCLUSION: In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.",

keywords = "Adult, Age Factors, Aged, Antineoplastic Agents, Immunological/adverse effects, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Female, Hematopoietic Stem Cell Transplantation/adverse effects, Humans, Lymphoma, Mantle-Cell/mortality, Male, Middle Aged, North America, Progression-Free Survival, Retrospective Studies, Risk Assessment, Risk Factors, Rituximab/adverse effects, Time Factors, Transplantation, Autologous, Young Adult",

author = "Gerson, {James N.} and Elizabeth Handorf and Diego Villa and Gerrie, {Alina S.} and Parv Chapani and Shaoying Li and {Jeffrey Medeiros}, L. and Wang, {Michael I.} and Cohen, {Jonathon B.} and Oscar Calzada and Churnetski, {Michael C.} and Hill, {Brian T.} and Yazeed Sawalha and Hernandez-Ilizaliturri, {Francisco J.} and Shalin Kothari and Vose, {Julie M.} and Bast, {Martin A.} and Fenske, {Timothy S.} and Gari, {Swapna Narayana Rao} and Maddocks, {Kami J.} and David Bond and Veronika Bachanova and Bhaskar Kolla and Julio Chavez and Bijal Shah and Frederick Lansigan and Burns, {Timothy F.} and Donovan, {Alexandra M.} and Nina Wagner-Johnston and Marcus Messmer and Amitkumar Mehta and Anderson, {Jennifer K.} and Nishitha Reddy and Kovach, {Alexandra E.} and Landsburg, {Daniel J.} and Martha Glenn and Inwards, {David J.} and Reem Karmali and Kaplan, {Jason B.} and Caimi, {Paolo F.} and Saurabh Rajguru and Andrew Evens and Andreas Klein and Elvira Umyarova and Bhargavi Pulluri and Amengual, {Jennifer E.} and Lue, {Jennifer K.} and Catherine Diefenbach and Fisher, {Richard I.} and Barta, {Stefan K.}",

note = "Publisher Copyright: {\textcopyright} 2019 by American Society of Clinical Oncology.",

year = "2019",

month = feb,

day = "20",

doi = "10.1200/JCO.18.00690",

language = "English (US)",

volume = "37",

pages = "471--480",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

publisher = "Lippincott Williams and Wilkins",

number = "6",

}

TY - JOUR

T1 - Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era

AU - Gerson, James N.

AU - Handorf, Elizabeth

AU - Villa, Diego

AU - Gerrie, Alina S.

AU - Chapani, Parv

AU - Li, Shaoying

AU - Jeffrey Medeiros, L.

AU - Wang, Michael I.

AU - Cohen, Jonathon B.

AU - Calzada, Oscar

AU - Churnetski, Michael C.

AU - Hill, Brian T.

AU - Sawalha, Yazeed

AU - Hernandez-Ilizaliturri, Francisco J.

AU - Kothari, Shalin

AU - Vose, Julie M.

AU - Bast, Martin A.

AU - Fenske, Timothy S.

AU - Gari, Swapna Narayana Rao

AU - Maddocks, Kami J.

AU - Bond, David

AU - Bachanova, Veronika

AU - Kolla, Bhaskar

AU - Chavez, Julio

AU - Shah, Bijal

AU - Lansigan, Frederick

AU - Burns, Timothy F.

AU - Donovan, Alexandra M.

AU - Wagner-Johnston, Nina

AU - Messmer, Marcus

AU - Mehta, Amitkumar

AU - Anderson, Jennifer K.

AU - Reddy, Nishitha

AU - Kovach, Alexandra E.

AU - Landsburg, Daniel J.

AU - Glenn, Martha

AU - Inwards, David J.

AU - Karmali, Reem

AU - Kaplan, Jason B.

AU - Caimi, Paolo F.

AU - Rajguru, Saurabh

AU - Evens, Andrew

AU - Klein, Andreas

AU - Umyarova, Elvira

AU - Pulluri, Bhargavi

AU - Amengual, Jennifer E.

AU - Lue, Jennifer K.

AU - Diefenbach, Catherine

AU - Fisher, Richard I.

AU - Barta, Stefan K.

PY - 2019/2/20

Y1 - 2019/2/20

N2 - PURPOSE: Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.PATIENTS AND METHODS: We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score-weighted (PSW) analysis were performed.RESULTS: Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).CONCLUSION: In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.

AB - PURPOSE: Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.PATIENTS AND METHODS: We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score-weighted (PSW) analysis were performed.RESULTS: Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).CONCLUSION: In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.

KW - Adult

KW - Age Factors

KW - Aged

KW - Antineoplastic Agents, Immunological/adverse effects

KW - Antineoplastic Combined Chemotherapy Protocols/adverse effects

KW - Female

KW - Hematopoietic Stem Cell Transplantation/adverse effects

KW - Humans

KW - Lymphoma, Mantle-Cell/mortality

KW - Male

KW - Middle Aged

KW - North America

KW - Progression-Free Survival

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Rituximab/adverse effects

KW - Time Factors

KW - Transplantation, Autologous

KW - Young Adult

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UR - http://www.scopus.com/inward/citedby.url?scp=85061614115&partnerID=8YFLogxK

U2 - 10.1200/JCO.18.00690

DO - 10.1200/JCO.18.00690

M3 - Article

C2 - 30615550

AN - SCOPUS:85061614115

SN - 0732-183X

VL - 37

SP - 471

EP - 480

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 6

ER -

Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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