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 journalArticle

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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 languageEnglish (US)
Pages (from-to)471-480
Number of pages10
JournalJournal of Clinical Oncology
Volume37
Issue number6
DOIs
StatePublished - Jan 1 2019

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Mantle-Cell Lymphoma
Cell Transplantation
Disease-Free Survival
Survival
Transplantation
Regression Analysis
Rituximab
Induction Chemotherapy
Cyclin D1
B-Cell Lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Gerson, J. N., Handorf, E., Villa, D., Gerrie, A. S., Chapani, P., Li, S., ... 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

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

In: Journal of Clinical Oncology, Vol. 37, No. 6, 01.01.2019, p. 471-480.

Research output: Contribution to journalArticle

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
Gerson, James N. ; Handorf, Elizabeth ; Villa, Diego ; Gerrie, Alina S. ; Chapani, Parv ; Li, Shaoying ; Jeffrey Medeiros, L. ; Wang, Michael I. ; Cohen, Jonathon B. ; Calzada, Oscar ; Churnetski, Michael C. ; Hill, Brian T. ; Sawalha, Yazeed ; Hernandez-Ilizaliturri, Francisco J. ; Kothari, Shalin ; Vose, Julie M. ; Bast, Martin A. ; Fenske, Timothy S. ; Gari, Swapna Narayana Rao ; Maddocks, Kami J. ; Bond, David ; Bachanova, Veronika ; Kolla, Bhaskar ; Chavez, Julio ; Shah, Bijal ; Lansigan, Frederick ; Burns, Timothy F. ; Donovan, Alexandra M. ; Wagner-Johnston, Nina ; Messmer, Marcus ; Mehta, Amitkumar ; Anderson, Jennifer K. ; Reddy, Nishitha ; Kovach, Alexandra E. ; Landsburg, Daniel J. ; Glenn, Martha ; Inwards, David J. ; Karmali, Reem ; Kaplan, Jason B. ; Caimi, Paolo F. ; Rajguru, Saurabh ; Evens, Andrew ; Klein, Andreas ; Umyarova, Elvira ; Pulluri, Bhargavi ; Amengual, Jennifer E. ; Lue, Jennifer K. ; Diefenbach, Catherine ; Fisher, Richard I. ; Barta, Stefan K. / Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era. In: Journal of Clinical Oncology. 2019 ; Vol. 37, No. 6. pp. 471-480.
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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.",
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.}",
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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 - 2019/1/1

Y1 - 2019/1/1

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.

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