Autologous stem cell transplantation in patients with mantle cell lymphoma

This study compared the effectiveness of autologous stem cell transplantation in patients with mantle cell lymphoma who either did or did not achieve a complete response after first line treatment. The study concluded that autologous stem cell transplantation is most useful for patients who have already achieved a complete response. 

Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma. MCL is usually aggressive, and is extremely difficult to cure. First-line treatment usually involves chemotherapy plus rituximab (Rituxan) followed by autologous stem cell transplantation (auto-SCT; using stem cells from the patient’s own body). Auto-SCT can be very effective at reducing the risk of relapse and increasing survival. More research is needed to determine how effective auto-SCT is for treating MCL patients. 

The medical records of 268 patients were reviewed. All patients had MCL. All patients were treated with auto-SCT. The average length of follow-up was 54 months.

39% of patients were treated with rituximab before auto-SCT. 53% of patients achieved a complete response (no detectable cancer) before auto-SCT. 26% achieved a partial response (reduction in tumor size) before auto-SCT. 19% of patients had relapsed disease. 2% of patients had MCL that was not responding to chemotherapy.

The average overall survival (time from treatment to death from any cause) for the whole group was 74 months. The average overall survival for patients who achieved a complete response was 97 months. Achieving a complete response before auto-SCT significantly improved overall survival.

Of the patients who did not achieve a complete response before auto-SCT, 70% achieved a complete response after auto-SCT. The average overall survival for these patients was 92 months. The average overall survival for patients who did not achieve a complete response after auto-SCT was 16 months.
 

The authors concluded that autologous stem cell transplantation is a good treatment option for patients who have achieved a complete or partial response before transplantation. They also suggested that auto-SCT may not be as effective for patients with who are not responding to chemotherapy or have relapsed.