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15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2): prolonged remissions without survival plateau

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Christian W Eskelund
  • Arne Kolstad
  • Mats Jerkeman
  • Riikka Räty
  • Anna Laurell
  • Sandra Eloranta
  • Karin E Smedby
  • Simon Husby
  • Lone B Pedersen
  • Niels S Andersen
  • Mikael Eriksson
  • Eva Kimby
  • Hans Bentzen
  • Outi Kuittinen
  • Grete F Lauritzsen
  • Herman Nilsson-Ehle
  • Elisabeth Ralfkiaer
  • Mats Ehinger
  • Christer Sundström
  • Jan Delabie
  • Marja-Liisa Karjalainen-Lindsberg
  • Christopher T Workman
  • Christian Garde
  • Erkki Elonen
  • Christian H Geisler

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 11·4 years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 12·7 and 8·5 years, 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 12 years, 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.

OriginalsprogEngelsk
TidsskriftBritish Journal of Haematology
Vol/bind175
Udgave nummer3
Sider (fra-til)410-418
Antal sider9
ISSN0007-1048
DOI
StatusUdgivet - nov. 2016

ID: 172816984