Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/20731
Title: A Multi-Center Retrospective Comparison of Induction Chemoimmunotherapy Regimens on Outcomes in Transplant-eligible Patients with Previously Untreated Mantle Cell Lymphoma.
Authors: Ng, Zi Yun;Bishton, Mark;Ritchie, David;Campbell, Robert;Gilbertson, Michael;Hill, Kate;Ratnasingam, Sumita;Schwarer, Anthony;Manos, Kate;Shorten, Sophie;Ng, Melissa;Nelson, Niles;Xin, Liu;De Mel Widanalage, Sanjay;Sunny, Tenny;Purtill, Duncan;Poon, Michelle;Johnston, Anna;Cochrane, Tara;Lee, Hui-Peng;Hapgood, Greg;Tam, Constantine;Opat, Stephen;Hawkes, Eliza;Seymour, John;Cheah, Chan Yoon
Affiliation: Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
Department of Haematology, Royal Melbourne Hospital & Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, Victoria, Australia
Department of Medical Oncology, Eastern Health, Box Hill, Victoria, Australia
Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Victoria, Australia
Medical School, University of Western Australia, Crawley, Western Australia, Australia
Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
Department of Haematology, St Vincent's Hospital, Fitzroy, Victoria, Australia
Department of Haematology, Royal Melbourne Hospital & Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, Victoria, Australia
Department of Medical Oncology, Olivia Newton John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Clinical Haematology, Monash Health and Monash University, Clayton, Victoria, Australia
Cancer Care Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
Clinical Haematology, Monash Health and Monash University, Clayton, Victoria, Australia
Department of Medical Oncology, Eastern Health, Box Hill, Victoria, Australia
Department of Haematology, Flinders Medical Centre, Bedford Park, South Australia, Australia
Department of Haematology, St Vincent's Hospital, Fitzroy, Victoria, Australia
Department of Haematology, Gold Coast University Hospital, Southport, Queensland, Australia
Department of Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia
Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Health System, Singapore
Department of Haematology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Health System, Singapore
Department of Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia
Department of Haematology, Gold Coast University Hospital, Southport, Queensland, Australia
Department of Haematology, Flinders Medical Centre, Bedford Park, South Australia, Australia
Cancer Care Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
Clinical Haematology, Monash Health and Monash University, Clayton, Victoria, Australia
Department of Haematology, Royal Melbourne Hospital & Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, Victoria, Australia
Department of Clinical Haematology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 15-Apr-2019
EDate: 2019
Citation: Hematological oncology 2019; online first: 15 April
Abstract: Mantle cell lymphoma (MCL) is an uncommon and typically aggressive form of lymphoma. Although often initially chemosensitive, relapse is common. Several induction and conditioning regimens are used in transplant eligible patients and the optimal approach remains unknown. We performed an international, retrospective study of transplant eligible patients to assess impact of induction chemo-immunotherapy and conditioning regimens on clinical outcomes. We identified 228 patients meeting inclusion criteria. Baseline characteristics were similar among the induction groups except for some variation in age. The type of induction chemo-immunotherapy received did not influence overall response rates (ORR) (0.43), progression free survival (PFS) (P>0.67) or overall survival (OS) (P>0.35) on multivariate analysis (PFS and OS). Delivery of ASCT was associated with favourable PFS and OS (0.01) on univariate analysis only; this benefit was not seen on multivariate analysis - PFS (0.36) and OS (0.21). Compared with BuMel (busulfan and melphalan), the use of the BEAM (carmustine, etoposide, cytarabine, melphalan) conditioning regimen was associated with inferior PFS (HR=2.0 [95%CI 1.1-3.6], 0.02) but not OS (HR=1.1 [95%CI 0.5-2.3] 0.81) on univariate analysis only. Within the limits of a retrospective study and modest power for some comparisons, type of induction therapy did not influence ORR, PFS or OS for transplant eligible patients with MCL. International efforts are required to perform randomized clinical trials evaluating chemo-immunotherapy induction regimens.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20731
DOI: 10.1002/hon.2618
ORCID: 0000-0001-5050-1223
PubMed URL: 30983008
Type: Journal Article
Subjects: Autologous Stem Cell Transplant
Conditioning
Induction
Mantle Cell Lymphoma
Appears in Collections:Journal articles

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