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Nordic MCL 2 trial update: six‐year follow‐up after intensive immunochemotherapy for untreated mantle cell lymphoma followed by BEAM or BEAC + autologous stem‐cell support: still very long survival but late relapses do occur

2012; Wiley; Volume: 158; Issue: 3 Linguagem: Inglês

10.1111/j.1365-2141.2012.09174.x

1365-2141

Christian H. Geisler, Arne Kolstad, Anna Laurell, Mats Jerkeman, Riikka Räty, Niels Smedegaard Andersen, Lone Bredo Pedersen, Mikael Eriksson, Marie Nordström, Eva Kimby, Hans Bentzen, Outi Kuittinen, Grete F. Lauritzsen, Herman Nilsson‐Ehle, Elisabeth Ralfkiær, Mats Ehinger, Christer Sundström, Jan Delabie, Marja‐Liisa Karjalainen‐Lindsberg, Peter de Nully Brown, Erkki Elonen,

CNS Lymphoma Diagnosis and Treatment

Mantle cell lymphoma (MCL) is a heterogenic non-Hodgkin lymphoma entity, with a median survival of about 5 years. In 2008 we reported the early - based on the median observation time of 4 years - results of the Nordic Lymphoma Group MCL2 study of frontline intensive induction immunochemotherapy and autologous stem cell transplantation (ASCT), with more than 60% event-free survival at 5 years, and no subsequent relapses reported. Here we present an update after a median observation time of 6·5 years. The overall results are still excellent, with median overall survival and response duration longer than 10 years, and a median event-free survival of 7·4 years. However, six patients have now progressed later than 5 years after end of treatment. The international MCL Prognostic Index (MIPI) and Ki-67-expression were the only independent prognostic factors. Subdivided by the MIPI-Biological Index (MIPI + Ki-67, MIPI-B), more than 70% of patients with low-intermediate MIPI-B were alive at 10 years, but only 23% of the patients with high MIPI-B. These results, although highly encouraging regarding the majority of the patients, underline the need of a risk-adapted treatment strategy for MCL. The study was registered at www.isrctn.org as ISRCTN 87866680.