Early relapse identifies MCL patients with inferior survival after intensive or less intensive frontline therapy

Blood Advances - Tập 5 - Trang 5179-5189 - 2021
David A. Bond1, Jeffrey M. Switchenko2, Diego Villa3,4, Kami Maddocks1, Michael Churnetski5, Alina S. Gerrie3,4, Subir Goyal2, Krithika Shanmugasundaram5, Oscar Calzada5, Bhaskar Kolla6, Veronika Bachanova6, James N. Gerson7,8, Stefan K. Barta7,8, Brian T. Hill9, Yazeed Sawalha1,9, Peter Martin10, Edward Maldonado11, Max Gordon11,12, Alexey V. Danilov11,13, Natalie S. Grover14
1Division of Hematology, The Ohio State University, Columbus, OH
2Winship Cancer Institute, Biostatistics and Bioinformatics, Emory University, Atlanta, GA
3Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, BC, Canada
4Division of Medical Oncology, University of British Columbia, Vancouver, BC, Canada
5Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
6Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
7Division of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
8Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA
9Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
10Division of Hematology and Oncology, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY
11Knight Cancer Institute, Oregon Health Sciences University, Portland, OR
12Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX
13Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA
14Division of Hematology, University of North Carolina, Chapel Hill, NC

Tóm tắt

Abstract Although an expanding array of effective treatments has resulted in recent improvement in survival of patients with mantle cell lymphoma (MCL), outcomes remain heterogeneous, and identification of prognostic factors remains a priority. We assessed the prognostic impact of time to progression of disease (POD) after first-line therapy among 455 patients with relapsed MCL. Patients were categorized by duration of first remission as PRF/POD6, defined as progressive disease during induction or POD within 6 months of diagnosis (n = 65; 14%); POD6-24, defined as POD between 6 and 24 months after diagnosis (n = 153; 34%); and POD>24, defined as POD >24 months after diagnosis (n = 237; 53%). The median overall survival from POD (OS2) was 1.3 years (95% confidence interval [CI], 0.9-2.4) for patients with PRF/POD6, 3 years (95% CI, 2-6.8) for those with POD6-24, and 8 years (95% CI, 6.2-NR) for those with POD>24. Median OS2 was inferior in patients with early POD (defined as PRF/POD6 or POD6-24) after both intensive and less intensive frontline treatment. The prognostic performance of time until POD was replicated in an independent cohort of 245 patients with relapsed MCL, with median OS2 of 0.3 years (95% CI, 0.1-0.5) for PRF/POD6, 0.8 years (95% CI, 0.6-0.9) for POD6-24, and 2.4 years (95% CI 2.1-2.7) for POD>24. Early POD is associated with inferior OS2 in patients with relapsed MCL, identifying a high-risk population for future prospective studies.

Tài liệu tham khảo

Epperla, 2018, Incidence and survival trends in mantle cell lymphoma, Br J Haematol., 181, 703, 10.1111/bjh.14699 Zhou, 2008, Incidence trends of mantle cell lymphoma in the United States between 1992 and 2004, Cancer., 113, 791, 10.1002/cncr.23608 Hermine, 2016, Addition of high-dose cytarabine to immunochemotherapy before autologous stem-cell transplantation in patients aged 65 years or younger with mantle cell lymphoma (MCL Younger): a randomised, open-label, phase 3 trial of the European Mantle Cell Lymphoma Network, Lancet., 388, 565, 10.1016/S0140-6736(16)00739-X Gerson, 2019, Survival outcomes of younger patients with mantle cell lymphoma treated in the rituximab era, J Clin Oncol., 37, 471, 10.1200/JCO.18.00690 Kumar, 2019, Patterns of survival in patients with recurrent mantle cell lymphoma in the modern era: progressive shortening in response duration and survival after each relapse, Blood Cancer J., 9, 50, 10.1038/s41408-019-0209-5 Geisler, 2008, Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group, Blood., 112, 2687, 10.1182/blood-2008-03-147025 Kamdar, 2019, Five-year outcomes of the S1106 study of R-hyper-CVAD vs R-bendamustine in transplant-eligible patients with mantle cell lymphoma, Blood Adv., 3, 3132, 10.1182/bloodadvances.2019000526 Merryman, 2020, Rituximab/bendamustine and rituximab/cytarabine induction therapy for transplant-eligible mantle cell lymphoma, Blood Adv., 4, 858, 10.1182/bloodadvances.2019001355 Villa, 2020, Bendamustine and rituximab as induction therapy in both transplant-eligible and -ineligible patients with mantle cell lymphoma, Blood Adv., 4, 3486, 10.1182/bloodadvances.2020002068 Hoster, 2008, A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma, Blood., 111, 558, 10.1182/blood-2007-06-095331 Geisler, 2010, The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT), Blood., 115, 1530, 10.1182/blood-2009-08-236570 Hoster, 2014, Confirmation of the mantle-cell lymphoma International Prognostic Index in randomized trials of the European Mantle-Cell Lymphoma Network, J Clin Oncol., 32, 1338, 10.1200/JCO.2013.52.2466 Delfau-Larue, 2015, High-dose cytarabine does not overcome the adverse prognostic value of CDKN2A and TP53 deletions in mantle cell lymphoma, Blood., 126, 604, 10.1182/blood-2015-02-628792 Determann, 2008, Ki-67 predicts outcome in advanced-stage mantle cell lymphoma patients treated with anti-CD20 immunochemotherapy: results from randomized trials of the European MCL Network and the German Low Grade Lymphoma Study Group, Blood., 111, 2385, 10.1182/blood-2007-10-117010 Eskelund, 2017, TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy, Blood., 130, 1903, 10.1182/blood-2017-04-779736 Greenwell, 2018, Complex karyotype in patients with mantle cell lymphoma predicts inferior survival and poor response to intensive induction therapy, Cancer., 124, 2306, 10.1002/cncr.31328 Casulo, 2015, Early relapse of follicular lymphoma after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone defines patients at high risk for death: an analysis from the National LymphoCare Study [published correction appears in J Clin Oncol. 2016;34(12):1430], J Clin Oncol., 33, 2516, 10.1200/JCO.2014.59.7534 Luminari, 2019, Early progression as a predictor of survival in marginal zone lymphomas: an analysis from the FIL-NF10 study, Blood., 134, 798, 10.1182/blood.2019001088 Tracy, 2019, The utility of prognostic indices, early events, and histological subtypes on predicting outcomes in non-follicular indolent B-cell lymphomas, Am J Hematol., 94, 658, 10.1002/ajh.25473 Jurinovic, 2016, Clinicogenetic risk models predict early progression of follicular lymphoma after first-line immunochemotherapy, Blood., 128, 1112, 10.1182/blood-2016-05-717355 Gisselbrecht, 2010, Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era, J Clin Oncol., 28, 4184, 10.1200/JCO.2010.28.1618 van Imhoff, 2017, Ofatumumab versus rituximab salvage chemoimmunotherapy in relapsed or refractory diffuse large B-cell lymphoma: The ORCHARRD Study, J Clin Oncol., 35, 544, 10.1200/JCO.2016.69.0198 Maurer, 2014, Event-free survival at 24 months is a robust end point for disease-related outcome in diffuse large B-cell lymphoma treated with immunochemotherapy, J Clin Oncol., 32, 1066, 10.1200/JCO.2013.51.5866 Dietrich, 2014, Outcome and prognostic factors in patients with mantle-cell lymphoma relapsing after autologous stem-cell transplantation: a retrospective study of the European Group for Blood and Marrow Transplantation (EBMT), Ann Oncol., 25, 1053, 10.1093/annonc/mdu097 Visco, 2019, Time to progression of mantle cell lymphoma after high-dose cytarabine-based regimens defines patients risk for death, Br J Haematol., 185, 940, 10.1111/bjh.15643 Salek, 2014, Retrospective analysis of 235 unselected patients with mantle cell lymphoma confirms prognostic relevance of Mantle Cell Lymphoma International Prognostic Index and Ki-67 in the era of rituximab: long-term data from the Czech Lymphoma Project Database, Leuk Lymphoma., 55, 802, 10.3109/10428194.2013.815349 Schaffel, 2010, Prognostic impact of proliferative index determined by quantitative image analysis and the International Prognostic Index in patients with mantle cell lymphoma, Ann Oncol., 21, 133, 10.1093/annonc/mdp495 Costa, 2017, Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies, Am J Hematol., 92, 161, 10.1002/ajh.24615 Seymour, 2019, Association of early disease progression and very poor survival in the GALLIUM study in follicular lymphoma: benefit of obinutuzumab in reducing the rate of early progression, Haematologica., 104, 1202, 10.3324/haematol.2018.209015 Abrisqueta, 2017, Observation as the initial management strategy in patients with mantle cell lymphoma, Ann Oncol., 28, 2489, 10.1093/annonc/mdx333 Rule, 2017, Outcomes in 370 patients with mantle cell lymphoma treated with ibrutinib: a pooled analysis from three open-label studies, Br J Haematol., 179, 430, 10.1111/bjh.14870 Pararajalingam, 2020, Coding and noncoding drivers of mantle cell lymphoma identified through exome and genome sequencing, Blood., 136, 572, 10.1182/blood.2019002385 Joffe, 2019, Genomic profiling of mantle cell lymphoma suggests poor-risk profile is present at diagnosis and does not arise by tumor evolution [abstract], Blood., 134, 10.1182/blood-2019-129563 Ferrero, 2020, KMT2D mutations and TP53 disruptions are poor prognostic biomarkers in mantle cell lymphoma receiving high-dose therapy: a FIL study, Haematologica., 105, 1604, 10.3324/haematol.2018.214056 Rule, 2019, Long-term outcomes with ibrutinib versus the prior regimen: a pooled analysis in relapsed/refractory mantle cell lymphoma with up to 7.5 years of extended follow-up [abstract], Blood., 134, 10.1182/blood-2019-124691 Visco, 2020, Outcomes in first relapsed-refractory younger patients with mantle cell lymphoma: results from the MANTLE-FIRST study [published correction appears in Leukemia. 2021;35(3):932], Leukemia., 35, 787, 10.1038/s41375-020-01013-3
Thông tin
Thông tin xuất bản

Blood Advances

Tập 5

5179-5189

Thông tin tác giả