1. Molecular remission is an independent predictor of clinical outcome in patients with mantle cell lymphoma after combined immunochemotherapy: a European MCL intergroup study.: MRD after immunochemotherapy in mantle-cell lymphoma
- Author
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Pott, Christiane, Hoster, Eva, Delfau-Larue, Marie-Hélène, Beldjord, Kheira, Böttcher, Sebastian, Asnafi, Vahid, Plonquet, Anne, Siebert, Reiner, Callet-Bauchu, Evelyne, Andersen, Niels, van Dongen, Jacques, Klapper, Wolfram, Berger, Françoise, Ribrag, Vincent, van Hoof, Achiel, Trneny, Marek, Walewski, Jan, Dreger, Peter, Unterhalt, Michael, Hiddemann, Wolfgang, Kneba, Michael, Kluin-Nelemans, Hanneke, Hermine, Olivier, Macintyre, Elizabeth, Dreyling, Martin, Second Medical Department, University Hospital Schleswig-Holstein, Department of Internal Medicine III, University of Munich, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'immunologie biologique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire d'hématologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institute of Human Genetics, Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Hematology, Rigshospitalet [Copenhagen], Copenhagen University Hospital-Copenhagen University Hospital, Department of Immunology, Department of Hematopathology, Schleswig-Holstein University Hospitals, Département de pathologie, Hospices Civils de Lyon (HCL), Laboratoire de recherche translationnelle, Direction de la recherche [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), University Hospital St Jan, 1st Dept. of Medicine, Charles University [Prague] (CU), Institute of Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (MCMCC), Department of Internal Medicine V, Heidelberg University Hospital [Heidelberg], University of Groningen [Groningen], Cytokines, hématopoïèse et réponse immune (CHRI), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), This work was supported by the European Community within the European MCL Network LSHC-CT 2004-503351 (CP, EM, MHDL, RS) and by the Lymphoma Research Foundation (CP, SB, MD) Correlative Research grant, ARC (association de recherche contre le Cancer) Subvention number 3730 (MHDL), Fondation de France (FDF) comité Leucémie, Subvention number 2004004029 (MHDL), ARTGIL (Association de recherche sur le traitement, la genétique et l'immunologie des lymphomes) (MHDL), European Project: 26849,EUROPEAN MCL NETWORK, Guellaen, Georges, and European Mantle Cell Lymphoma Network: Tranlational determination of molecular prognostic factors and pharmacogenomics in a European interdisciplinary collaboration - EUROPEAN MCL NETWORK - 26849 - OLD
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immunochemotherapy ,[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology ,autologous stem cell transplantation ,MRD ,hemic and lymphatic diseases ,RQ-PCR ,mantle cell lymphoma ,minimal residual disease ,[SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology ,[SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology - Abstract
International audience; The prognostic impact of minimal residual disease (MRD) was analyzed in 259 patients with mantle cell lymphoma (MCL) treated within 2 randomized trials of the European MCL Network (MCL Younger and MCL Elderly trial). After rituximab-based induction treatment, 106 of 190 evaluable patients (56%) achieved a molecular remission (MR) based on blood and/or bone marrow (BM) analysis. MR resulted in a significantly improved response duration (RD; 87% vs 61% patients in remission at 2 years, P = .004) and emerged to be an independent prognostic factor for RD (hazard ratio = 0.4, 95% confidence interval, 0.1-0.9, P = .028). MR was highly predictive for prolonged RD independent of clinical response (complete response [CR], complete response unconfirmed [CRu], partial response [PR]; RD at 2 years: 94% in BM MRD-negative CR/CRu and 100% in BM MRD-negative PR, compared with 71% in BM MRD-positive CR/CRu and 51% in BM MRD-positive PR, P = .002). Sustained MR during the postinduction period was predictive for outcome in MCL Younger after autologous stem cell transplantation (ASCT; RD at 2 years 100% vs 65%, P = .001) and during maintenance in MCL Elderly (RD at 2 years: 76% vs 36%, P = .015). ASCT increased the proportion of patients in MR from 55% before high-dose therapy to 72% thereafter. Sequential MRD monitoring is a powerful predictor for treatment outcome in MCL. These trials are registered at www.clinicaltrials.gov as #NCT00209222 and #NCT00209209.
- Published
- 2010
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