Death from mantle cell lymphoma limits sequential therapy, particularly after first relapse: Patterns of care and outcomes in a series from Australia and the United Kingdom.

2023-10-30

Minson, Adrian

Hamad, Nada

Di Ciaccio, Pietro

Talaulikar, Dipti

Ku, Matthew

Ratnasingam, Sumita

Cheah, Chan

Yannakou, Costas K

Bishton, Mark

Ng, Zi Yun

Agrawal, Shivam

McQuillan, Andrew

Johnston, Anna

Choong, Emily

Wong, Kimberly

McQuillan, James

Beekman, Ashley

Hawkes, Eliza A

Dickinson, Michael

lymphoid malignancies

lymphomas

new drugs for lymphoma

Journal Article

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0000-0001-7929-1450

0000-0002-9282-8619

0000-0001-6766-8345

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0000-0002-0376-2559

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10.1111/bjh.19179

Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T-cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma-related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10-year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second-line treatment. This limitation of sequential treatment by lymphoma-related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high-risk patient populations.

link

British Journal of Haematology 2023-10-30

British Journal of Haematology

1365-2141