Bendamustine or high-dose cytarabine-based induction with rituximab in transplant-eligible mantle cell lymphoma

Villa, Diego; Hoster, Eva; Hermine, Olivier; Klapper, Wolfram; Szymczyk, Michal; Bosly, Andre; Unterhalt, Michael; Rimsza, Lisa M.; Ramsower, Colleen A.; Freeman, Ciara L.; Scott, David W.; Gerrie, Alina S.; Savage, Kerry J.; Sehn, Laurie H. und Dreyling, Martin (2022): Bendamustine or high-dose cytarabine-based induction with rituximab in transplant-eligible mantle cell lymphoma. In: Blood Advances, Bd. 6, Nr. 18: S. 5285-5294

Abstract

The objective of this study was to explore differences in outcomes between first-line rituximab plus bendamustine (R-B) and R-CHOP/R-DHAP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone, dexamethasone, cytarabine, cisplatin) in transplant-eligible patients with mantle cell lymphoma (MCL). A population-based cohort of 97 patients aged 18 to 65 years with stage II-IV MCL, consecutively treated with R-B was retrospectively identified at BC Cancer. Baseline characteristics, response rates, and outcomes were compared with the cohort of 232 patients with MCL randomized to the R-CHOP/R-DHAP arm of the MCL Younger trial. The primary endpoint was the hazard ratio (HR) of the progression-free survival (PFS) comparison between both groups, adjusted for MCL International Prognostic Index (MIPI), Ki67 index, and blastoid/ pleomorphic morphology. Ann Arbor stage, lactate dehydrogenase, MIPI, blastoid morphology, and MCL35 assignments were similar between both groups. The overall response rate (ORR) to R-B was 90% (54% complete response [CR]);77% of patients proceeded to autologous stem cell transplantation (ASCT) and 78% received maintenance rituximab (MR). The ORR to R-CHOP/R-DHAP was 94% (54% CR);78% proceeded to ASCT and 2% received MR. There were no differences in PFS in unadjusted (HR, 0.87;95% confidence interval [CI], 0.53-1.41;P = .56) or adjusted (HR, 0.79;95% CI, 0.45-1.37;P = .40) comparisons. There were no clear differences in secondary endpoints in unadjusted or adjusted analyses. This retrospective adjusted comparison of 2 independent cohorts of younger patients with MCL suggests that R-B with ASCT and maintenance rituximab is a feasible and effective first-line treatment, with outcomes comparable to R-CHOP/R-DHAP with ASCT.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2473-9529
• Sprache: Englisch