In a nutshell
This study reported on the long-term outcome of intensive immunochemotherapy and stem cell transplantation in patients with mantle cell lymphoma. This study concluded that long-term results were encouraging but highlighted the need for personalized treatment options.
Some background
The combination of intensive chemotherapy combined with rituximab (Rituxan) followed by high-dose chemotherapy and stem cell transplantation (SCT) has improved survival in mantle cell lymphoma. The long-term success of this treatment regimen is still unclear. One trial reported no relapses in 160 patients 5 years after transplantation. Whether this treatment schedule is successful after more than 5 years is still under investigation.
Methods & findings
This study examined the long-term success of SCT in patients who were relapse-free after 5 years. 145 patients had all been treated with rituximab and an intense version of the chemotherapy combination CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone). The chemotherapy cytarabine was also used. After stem cell harvest (removal), patients were treated with high-dose chemotherapy (various combinations) and SCT. Patients were followed for an average of 6.5 years (a range of 4 to 10 years).
The average time from treatment until progression, treatment failure, or death was 7.4 years. Six patients progressed after more than 5 years.
Certain factors predicted outcome in patients. These included performance status (ability of the patient to function in daily life) and Ki67 levels. Ki67 is a protein that indicates cancer cell growth. More than 70% of patients who were considered low-intermediate risk were alive at 10 years. 23% of patients considered high-risk were alive at 10 years.
The bottom line
This study concluded that rituximab and chemotherapy, followed by high-dose chemotherapy and SCT, led to long-term success in many patients. The authors suggested that treatment strategies should be based on the risk level of the individual patient.
Published By :
British Journal of Haematology
Date :
Aug 01, 2012
