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 journalArticlepeer-review

70 Scopus citations


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 languageEnglish (US)
Pages (from-to)471-480
Number of pages10
JournalJournal of Clinical Oncology
Issue number6
StatePublished - Feb 20 2019

Bibliographical note

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


  • 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


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