TY - JOUR
T1 - 15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2)
T2 - prolonged remissions without survival plateau
AU - Eskelund, Christian W
AU - Kolstad, Arne
AU - Jerkeman, Mats
AU - Räty, Riikka
AU - Laurell, Anna
AU - Eloranta, Sandra
AU - Smedby, Karin E
AU - Husby, Simon
AU - Pedersen, Lone B
AU - Andersen, Niels S
AU - Eriksson, Mikael
AU - Kimby, Eva
AU - Bentzen, Hans
AU - Kuittinen, Outi
AU - Lauritzsen, Grete F
AU - Nilsson-Ehle, Herman
AU - Ralfkiaer, Elisabeth
AU - Ehinger, Mats
AU - Sundström, Christer
AU - Delabie, Jan
AU - Karjalainen-Lindsberg, Marja-Liisa
AU - Workman, Christopher T
AU - Garde, Christian
AU - Elonen, Erkki
AU - Brown, Peter
AU - Grønbaek, Kirsten
AU - Geisler, Christian H
N1 - © 2016 John Wiley & Sons Ltd.
PY - 2016/11
Y1 - 2016/11
N2 - In recent decades, the prognosis of Mantle Cell Lymphoma (MCL) has been significantly improved by intensified first-line regimens containing cytarabine, rituximab and consolidation with high-dose-therapy and autologous stem cell transplantation. One such strategy is the Nordic MCL2 regimen, developed by the Nordic Lymphoma Group. We here present the 15-year updated results of the Nordic MCL2 study after a median follow-up of 11·4 years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 12·7 and 8·5 years, respectively. The MCL International Prognostic Index (MIPI), biological MIPI, including Ki67 expression (MIPI-B) and the MIPI-B including mIR-18b expression (MIPI-B-miR), in particular, significantly divided patients into distinct risk groups. Despite very long response durations of the low and intermediate risk groups, we observed a continuous pattern of relapse and the survival curves never reached a plateau. In conclusion, despite half of the patients being still alive and 40% in first remission after more than 12 years, we still see an excess disease-related mortality, even among patients experiencing long remissions. Even though we consider the Nordic regimen as a very good choice of regimen, we recommend inclusion in prospective studies to explore the benefit of novel agents in the frontline treatment of MCL.
AB - In recent decades, the prognosis of Mantle Cell Lymphoma (MCL) has been significantly improved by intensified first-line regimens containing cytarabine, rituximab and consolidation with high-dose-therapy and autologous stem cell transplantation. One such strategy is the Nordic MCL2 regimen, developed by the Nordic Lymphoma Group. We here present the 15-year updated results of the Nordic MCL2 study after a median follow-up of 11·4 years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 12·7 and 8·5 years, respectively. The MCL International Prognostic Index (MIPI), biological MIPI, including Ki67 expression (MIPI-B) and the MIPI-B including mIR-18b expression (MIPI-B-miR), in particular, significantly divided patients into distinct risk groups. Despite very long response durations of the low and intermediate risk groups, we observed a continuous pattern of relapse and the survival curves never reached a plateau. In conclusion, despite half of the patients being still alive and 40% in first remission after more than 12 years, we still see an excess disease-related mortality, even among patients experiencing long remissions. Even though we consider the Nordic regimen as a very good choice of regimen, we recommend inclusion in prospective studies to explore the benefit of novel agents in the frontline treatment of MCL.
U2 - 10.1111/bjh.14241
DO - 10.1111/bjh.14241
M3 - Journal article
C2 - 27378674
VL - 175
SP - 410
EP - 418
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 3
ER -