15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2): Prolonged remissions without survival plateau

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In recent decades, the prognosis of Mantle Cell Lymphoma (MCL) has been significantly improved by intensified first-line regimens containing cytarabine, rituximab and consolidation with high-dose-therapy and autologous stem cell transplantation. One such strategy is the Nordic MCL2 regimen, developed by the Nordic Lymphoma Group. We here present the 15-year updated results of the Nordic MCL2 study after a median follow-up of 11·4 years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 12·7 and 8·5 years, respectively. The MCL International Prognostic Index (MIPI), biological MIPI, including Ki67 expression (MIPI-B) and the MIPI-B including mIR-18b expression (MIPI-B-miR), in particular, significantly divided patients into distinct risk groups. Despite very long response durations of the low and intermediate risk groups, we observed a continuous pattern of relapse and the survival curves never reached a plateau. In conclusion, despite half of the patients being still alive and 40% in first remission after more than 12 years, we still see an excess disease-related mortality, even among patients experiencing long remissions. Even though we consider the Nordic regimen as a very good choice of regimen, we recommend inclusion in prospective studies to explore the benefit of novel agents in the frontline treatment of MCL.


  • Christian W. Eskelund
  • Arne Kolstad
  • Riikka Räty
  • Anna Laurell
  • Sandra Eloranta
  • Karin E. Smedby
  • Simon Husby
  • Lone B. Pedersen
  • Niels S. Andersen
  • Eva Kimby
  • Hans Bentzen
  • Outi Kuittinen
  • Grete F. Lauritzsen
  • Herman Nilsson-Ehle
  • Elisabeth Ralfkiær
  • Christer Sundström
  • Jan Delabie
  • Marja Liisa Karjalainen-Lindsberg
  • Christopher T. Workman
  • Christian Garde
  • Erkki Elonen
  • Peter Brown
  • Kirsten Grønbæk
  • Christian H. Geisler
Enheter & grupper
Externa organisationer
  • Copenhagen University Hospital
  • Oslo university hospital
  • Skåne University Hospital
  • Helsinki University Central Hospital
  • Uppsala University Hospital
  • Karolinska Institute
  • Aarhus University Hospital
  • Oulu University Hospital
  • Sahlgrenska University Hospital
  • University of Copenhagen

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Hematologi


Sidor (från-till)410-418
TidskriftBritish Journal of Haematology
Tidigt onlinedatum2016
StatusPublished - 2016
Peer review utfördJa