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著者: James N Gerson, Elizabeth Handorf, Diego Villa, Alina S Gerrie, Parv Chapani, Shaoying Li, L Jeffrey Medeiros, Michael I Wang, Jonathon B Cohen, Oscar Calzada, Michael C Churnetski, Brian T Hill, Yazeed Sawalha, Francisco J Hernandez-Ilizaliturri, Shalin Kothari, Julie M Vose, Martin A Bast, Timothy S Fenske, Swapna Narayana Rao Gari, Kami J Maddocks, David Bond, Veronika Bachanova, Bhaskar Kolla, Julio Chavez, Bijal Shah, Frederick Lansigan, Timothy F Burns, Alexandra M Donovan, Nina Wagner-Johnston, Marcus Messmer, Amitkumar Mehta, Jennifer K Anderson, Nishitha Reddy, Alexandra E Kovach, Daniel J Landsburg, Martha Glenn, David J Inwards, Reem Karmali, Jason B Kaplan, Paolo F Caimi, Saurabh Rajguru, Andrew Evens, Andreas Klein, Elvira Umyarova, Bhargavi Pulluri, Jennifer E Amengual, Jennifer K Lue, Catherine Diefenbach, Richard I Fisher, Stefan K Barta
雑誌名: J Clin Oncol. 2019 Feb 20;37(6):471-480. doi: 10.1200/JCO.18.00690. Epub 2019 Jan 7.
Abstract/Text
PURPOSE: Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.
PATIENTS AND METHODS: We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score-weighted (PSW) analysis were performed.
RESULTS: Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).
CONCLUSION: In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.
PMID 30615550 J Clin Oncol. 2019 Feb 20;37(6):471-480. doi: 10.1200/JCO.18.00690. Epub 2019 Jan 7.
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