Maintenance rituximab in newly diagnosed mantle cell lymphoma patients: a real world analysis from the Czech lymphoma study group registry^†

Abstract

We analyzed 495 MCL patients from the Czech Lymphoma Study Group data registry. With the median follow-up of 4.4 years, 51.7% patients progressed or relapsed and 34.1% died. Five-year overall survival reached 65.3% and five-year progression free survival 44.1% of the patients. Maintenance rituximab (MR) after first line therapy improved overall and progression free survival compared to the patients under observation only (both p < .001). Elevated beta-2-microglobulin (p = .003), presence of systemic symptoms (p = .002), ECOG >0 (p = .003), age (p = .014), and MIPI (p < .001) were associated with MR failure. Patients who did not achieve complete remission have had two-fold higher risk of MR failure (p < .001). Autologous stem cell transplant reduced the risk of MR failure by 69% (p < .001). The MIPI and the beta-2-microglobulin were identified as independent predictors of MR failure (p = .02 and p = .03, respectively). Patients who relapsed/progressed on MR reached shorter OS calculated from the MR start compared to patients without failure (HR = 15.0; p < .001).

Improvement in the outcomes of mantle cell lymphoma in the last decade: a real-life non interventional study of the Croatian Cooperative Group for Hematologic Diseases

“…Blastoid morphology and high MIPI remain important negative prognostic factors irrespective of the front-line therapy. This is equivalent to the results of other population-based studies analyzing biologic prognostic factors ( 7 , 8 , 11 ). The lack of difference in outcomes between patients with low and intermediate MIPI might be a consequence of the low number of treated patients with very favorable disease characteristics in our study, but although not always stated explicitly, seems also to have been noted in other real-life studies.…”

“…With rituximab maintenance, we observed improved EFS, but not OS. Other real-life studies found improvement in both EFS and OS ( 7 , 10 , 11 ). The lack of effect on OS in our study might be due to short follow-up, but in at least one real-life study maintenance influenced neither OS nor EFS ( 8 ).…”

Advances in Molecular Biology and Targeted Therapy of Mantle Cell Lymphoma

“…Bortezomib, in combination with cyclophosphamide, doxorubicin, and prednisone (so-called VR-CAP), was the only immunochemotherapy regimen that was associated with prolonged overall survival (OS) compared to R-CHOP in a phase III randomized trial [95]. Elderly patients treated with an R-CHOP-like regimen benefit from RM [5,96,97,98]. Maintenance therapies other than rituximab are currently tested in diverse clinical trials including lenalidomide or bortezomib [99,100].…”

Rituximab maintenance significantly reduces early follicular lymphoma progressions in patients treated with frontline R‐CHOP

“…Details about the development and operation of the CLSG lymphoma registry have been published elsewhere [ 2 , 17 , 18 ]. Briefly, the CLSG database is a nation‐wide prospectively operated registry collecting data since 1999.…”