Nordic MCL2 trial update: six-year follow-up after intensive immunochemotherapy for untreated mantle cell lymphoma followed by BEAM or BEAC plus autologous stem-cell support: still very long survival but late relapses do occur

TY - JOUR

T1 - Nordic MCL2 trial update: six-year follow-up after intensive immunochemotherapy for untreated mantle cell lymphoma followed by BEAM or BEAC plus autologous stem-cell support: still very long survival but late relapses do occur

AU - Geisler, Christian H.

AU - Kolstad, Arne

AU - Laurell, Anna

AU - Jerkeman, Mats

AU - Raty, Riikka

AU - Andersen, Niels S.

AU - Pedersen, Lone B.

AU - Eriksson, Mikael

AU - Nordstrom, Marie

AU - Kimby, Eva

AU - Bentzen, Hans

AU - Kuittinen, Outi

AU - Lauritzsen, Grete F.

AU - Nilsson-Ehle, Herman

AU - Ralfkiaer, Elisabeth

AU - Ehinger, Mats

AU - Sundstrom, Christer

AU - Delabie, Jan

AU - Karjalainen-Lindsberg, Marja-Liisa

AU - Brown, Peter

AU - Elonen, Erkki

PY - 2012

Y1 - 2012

N2 - Mantle cell lymphoma (MCL) is a heterogenic non-Hodgkin lymphoma entity, with a median survival of about 5 years. In 2008 we reported the early based on the median observation time of 4 years results of the Nordic Lymphoma Group MCL2 study of frontline intensive induction immunochemotherapy and autologous stem cell transplantation (ASCT), with more than 60% event-free survival at 5 years, and no subsequent relapses reported. Here we present an update after a median observation time of 6.5 years. The overall results are still excellent, with median overall survival and response duration longer than 10 years, and a median event-free survival of 7.4 years. However, six patients have now progressed later than 5 years after end of treatment. The international MCL Prognostic Index (MIPI) and Ki-67-expression were the only independent prognostic factors. Subdivided by the MIPI-Biological Index (MIPI + Ki-67, MIPI-B), more than 70% of patients with low-intermediate MIPI-B were alive at 10 years, but only 23% of the patients with high MIPI-B. These results, although highly encouraging regarding the majority of the patients, underline the need of a risk-adapted treatment strategy for MCL. The study was registered at as ISRCTN 87866680.

AB - Mantle cell lymphoma (MCL) is a heterogenic non-Hodgkin lymphoma entity, with a median survival of about 5 years. In 2008 we reported the early based on the median observation time of 4 years results of the Nordic Lymphoma Group MCL2 study of frontline intensive induction immunochemotherapy and autologous stem cell transplantation (ASCT), with more than 60% event-free survival at 5 years, and no subsequent relapses reported. Here we present an update after a median observation time of 6.5 years. The overall results are still excellent, with median overall survival and response duration longer than 10 years, and a median event-free survival of 7.4 years. However, six patients have now progressed later than 5 years after end of treatment. The international MCL Prognostic Index (MIPI) and Ki-67-expression were the only independent prognostic factors. Subdivided by the MIPI-Biological Index (MIPI + Ki-67, MIPI-B), more than 70% of patients with low-intermediate MIPI-B were alive at 10 years, but only 23% of the patients with high MIPI-B. These results, although highly encouraging regarding the majority of the patients, underline the need of a risk-adapted treatment strategy for MCL. The study was registered at as ISRCTN 87866680.

KW - mantle cell lymphoma

KW - autologous stem cell transplant

KW - high-dose AraC

KW - rituximab

KW - pre-emptive therapy

UR - https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.12006

U2 - 10.1111/j.1365-2141.2012.09174.x

DO - 10.1111/j.1365-2141.2012.09174.x

M3 - Article

VL - 158

SP - 355

EP - 362

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 3

ER -