Key result
Early mantle cell lymphoma progression is linked to a ~24-month shorter median overall survival.
Why the study?
Mantle cell lymphoma is currently considered incurable, and while some patients achieve prolonged remission after first-line chemoimmunotherapy, many require multiple treatment lines.
What are the real-world treatment trajectories, progression-free survival, and overall survival outcomes across multiple lines of therapy in patients with mantle cell lymphoma?
Observational (n=1,367)
Yes
What are the real-world treatment trajectories, progression-free survival, and overall survival outcomes across multiple lines of therapy in patients with mantle cell lymphoma?
Answers are grounded in this paper and cite their sources.
This nationwide Swedish cohort provides real-world benchmarks for progression-free survival across multiple lines of therapy in mantle cell lymphoma, demonstrating progressively shorter remissions with subsequent treatments.
Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL. All patients diagnosed with MCL 2006-2018 were identified in the Swedish Lymphoma Register. Information on all lines of therapy was extracted from the medical records. Overall and progression-free survival (OS and PFS) were assessed through August 2021. In total, 1367 patients were included (median age, 71 years) and median follow-up was 6.8 years. Two hundred and one (15%) were managed initially with watch-and-wait, but 1235 (90%) eventually received treatment. The most frequently used first-line regimens were rituximab-bendamustine (BR) (n = 368; 30%) and Nordic MCL2 (n = 342; 28%). During follow-up, 630 patients (46%) experienced relapse/progression and 546 (40%) received second-line treatment. The most frequently used second-line regimen was BR (n = 185; 34%) but otherwise a wide variety of second-line treatments were used. Further, 382 and 228 patients experienced a second or third relapse/progression, respectively. Median PFS after first (PFS-1), second (PFS-2), third (PFS-3), and fourth (PFS-4) treatment lines was 29.4, 8.9, 4.3, and 2.7 months. Patients with early progression, defined as a PFS-1 <24 months, had an inferior median OS of 13 versus 37 months in patients with later relapse. For patients treated with frontline BR, however, time to relapse had no impact on later outcome. By use of nationwide population-based data, we provide important benchmarks for future studies of all treatment lines in MCL.
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Jerkeman et al. (2023) conducted an observational in Mantle Cell Lymphoma (n=1,367). Early progression (POD24) after first-line treatment vs. Late progression (relapse ≥24 months) was evaluated on Median overall survival (months). Patients with mantle cell lymphoma who experienced early progression within 24 months of first-line treatment had an inferior median overall survival of 13 months compared to 37 months for those with later relapse.
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