Naslov
IMPROVEMENTS IN OUTCOME OF MANTLE-CELL LYMPHOMA (MCL) ARE MOSTLY DUE TO ADVANCES IN INDUCTION THERAPY AND AUTOLOGOUS STEM-CELL TRANSPLANTATION (ASCT) - A REAL-LIFE NON- INTERVENTIONAL STUDY OF KROHEM

Autori
Aurer, Igor ; Mišura Jakobac, Karla ; Sinčić- Petricevic, Jasminka ; Deak, Dajana, Vodanović, Mario ; Jakic-Bubalo, Marina ; Mitrović, Zdravko ; Grubesic Aron ; Dreta Barbara ; Zupanic-Krmek, Dubravka, Coha Božena

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
HemaSphere / - , 2019, 579-579

Skup
24th Congress of the European Hematology Association

Mjesto i datum
Amsterdam, Nizozemska, 13.06.2019. - 16.06.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Recenziran

Ključne riječi
Limfom plaštene zone, autologna transplantacija perifernih matičnih stanica, KROHEM studija
(MANTLECELL LYMPHOMA, AUTOLOGOUS STEMCELL TRANSPLANTATION, STUDY OF KROHEM)

Sažetak
Background: Outcome of patients with newly diagnosed MCL has improved substantially in the last decade. This coincided with the more frequent use of high-dose cytarabine (HD-AraC) and bendamustine (B) containing induction regimens, ASCT in first remission and rituximab (R) maintenance. Some real-life studies suggested that the latter was most important. Aims: KroHem, the Croatian Cooperative Group for Hematologic Diseases initiated this study to analyze outcomes of patients with MCL who started treatment or were diagnosed between 2015 and 2017 (recent cohort), identify prognostic factors and compare the results to those of a historical cohort who started treatment between 2007 and 2008. Methods: This was a retrospective study including all patients with MCL fulfilling the entry criteria seen at participating centers during the defined periods. Results: In the recent cohort 83 patients were treated, 2 received supportive care only and 5 had indolent disease and were observed. Median age was 68, 68% were male. All 40 patients in the historical cohort were treated, their median age was 67, 70% were male. All treated patients received R. Median follow up of the recent cohort was 20 mo and of the historical 39 mo. 2-year overall survival (OS) of treated patients increased from 57% to 81% and 2-year event free survival (EFS) from 41% to 57%. None of the indolent MCL patients progressed. MIPI, age and cytology were significant prognostic factors in the recent cohort for OS (p values 0.006, 0.006 and 0.013 respectively) and EFS (p values <0.001, 0.002 and 0.014 respectively). The difference in EFS between cohorts was more pronounced in patients below 65 (74% vs. 45% at 2 years) than in the elderly (41% vs. 39%) while OS improved in both age groups, but more in the younger (92% vs. 62% in younger and 70% vs. 51% in older patients at 2 years). Induction treatment and ASCT were statistically significant prognostic factors for EFS in the recent cohort. Patients treated with HD-AraC had the best outcomes, those treated with BR intermediate, while those receiving R-CHOP-like regimens fared worst (2-year EFS 80%, 61% and 38%, respectively ; p = 0.016). EFS of R-CHOP treatment patients did not differ between cohorts (38% in the recent vs. 42% in the historical cohort at 2 years). In the recent cohort 35% of patients with an EFS >6 mo received ASCT compared to 12.5% in the historical ; outcome of transplanted patients was similar (2-year EFS 83% vs. 80%). In the recent cohort 44% patients with EFS >6 mo received R maintenance, this did not seem to have a major impact on either OS (p = 0.993) or EFS (p = 0, 229). Summary/Conclusion: Our data suggest that the use of HD-AraC and BR in induction and more widespread ASCT in first remission are most important factors contributing to the improvement in outcomes of newly diagnosed patients with MCL. The lack of prognostic significance of R maintenance is probably due to short follow-up.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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