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15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2): prolonged remissions without survival plateau
- Source :
- Eskelund, C W, Kolstad, A, Jerkeman, M, Räty, R, Laurell, A, Eloranta, S, Smedby, K E, Husby, S, Pedersen, L B, Andersen, N S, Eriksson, M, Kimby, E, Bentzen, H, Kuittinen, O, Lauritzsen, G F, Nilsson-Ehle, H, Ralfkiaer, E, Ehinger, M, Sundström, C, Delabie, J, Karjalainen-Lindsberg, M-L, Workman, C, Garde, C, Elonen, E, Brown, P, Grønbaek, K & Geisler, C H 2016, ' 15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2) : prolonged remissions without survival plateau ', British Journal of Haematology, vol. 175, no. 3, pp. 410–418 . https://doi.org/10.1111/bjh.14241
- Publication Year :
- 2016
-
Abstract
- 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 114years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 127 and 85years, 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 12years, 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.
- Subjects :
- Oncology
Male
Lymphoma, Mantle-Cell
Clinical trials
0302 clinical medicine
Autologous stem-cell transplantation
International Prognostic Index
Recurrence
Antineoplastic Combined Chemotherapy Protocols
High dose therapy
MULTICENTER TRIAL
Remission Induction
Hematology
Middle Aged
Prognosis
HIGH-DOSE CYTARABINE
METHOTREXATE
3. Good health
Treatment Outcome
high dose therapy
030220 oncology & carcinogenesis
INITIAL TREATMENT
Rituximab
Female
medicine.drug
Bendamustine
Adult
medicine.medical_specialty
Non-Hodgkin Lymphoma
3122 Cancers
PHASE-2
IMMUNOCHEMOTHERAPY
03 medical and health sciences
Clinical Trials, Phase II as Topic
Internal medicine
medicine
Humans
Mortality
Survival analysis
Aged
Neoplasm Staging
clinical trials
PLUS RITUXIMAB
TRANSPLANTATION
business.industry
Mantle Cell Lymphoma
medicine.disease
Surgery
Transplantation
Regimen
3121 General medicine, internal medicine and other clinical medicine
Mantle cell lymphoma
BENDAMUSTINE
business
Biomarkers
030215 immunology
Follow-Up Studies
Subjects
Details
- ISSN :
- 13652141
- Volume :
- 175
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- British journal of haematology
- Accession number :
- edsair.doi.dedup.....e2af81699cb9b1313e4546f3336a4479