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

Scientific paper - Original scientific paper

• Author: Sandra Bašić-Kinda
• Author: Karla Mišura Jakobac
• Author: Jasminka Sinčić-Petričević
• Author: Dajana Deak
• Author: Marijo Vodanović
• Author: Marinka Jakić-Bubalo
• Author: Zdravko Mitrović
• Author: Aron Grubešić
• Author: Barbara Dreta
• Author: Dubravka Županić Krmek
• Author: Božena Coha
• Author: Delfa Radić-Krišto
• Author: Igor Aurer
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Aim: To compare the outcomes of Croatian patients with mantle cell lymphoma (MCL) who started treatment in 2007 and 2008 (historical cohort) and of those who started treatment between 2015 and 2017 (recent cohort).
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Methods: The historical cohort consisted of 40 patients who started treatment with rituximab in 2007 and 2008. Data on the recent cohort, consisting of 89 patients, were collected retrospectively from the electronic databases of Croatian hospitals with hematology units. Demographic characteristics and data on induction regimens, autologous stem cell transplantation (ASCT), and rituximab maintenance in the first remission, event-free survival (EFS), and overall survival (OS) were available for both cohorts, and data on cell morphology, mantle cell international prognostic index (MIPI), and Ki67 expression only for the recent cohort.
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Results: The recent cohort had significantly better two-year EFS and OS (EFS 58% vs 40%, P=0.014; OS 80% vs 56%, P=0.009), especially in patients below 65. In univariate analysis, induction regimen, ASCT, and maintenance were significant prognostic factors for EFS and the former two for OS. In the multivariate analysis, only ASCT remained significant. Bendamustine+rituximab (BR) induction improved the outcomes of non-transplantable patients over R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, steroid). Blastoid morphology and high MIPI were adverse prognostic factors for EFS and OS.
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Conclusion: In the last decade, the outcome of newly diagnosed MCL patients improved. ASCT in the first remission was the main contributor in transplantable patients and BR in non-transplantable. Regularly updated national guidelines may help in a timely adoption of new treatments, thus improving the results.

• Keywords (english): Antibodies, Monoclonal, Murine-Derived / therapeutic use; Antineoplastic Combined Chemotherapy Protocols / therapeutic use; Croatia; Hematologic Diseases*; Hematopoietic Stem Cell Transplantation*; Humans; Lymphoma, Mantle-Cell* / drug therapy; Retrospective Studies; Transplantation, Autologous
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 62, no. 5, pp. 455-463
• p-ISSN: 0353-9504
• e-ISSN: 1332-8166
• DOI: https://doi.org/10.3325/cmj.2021.62.455-6
• URN:NBN: urn:nbn:hr:105:886663
• Publication: 2021-10-31
• Document URL: http://www.cmj.hr/2021/62/5/34730885.htm
• Type of resource: Text
• Access conditions: Open access
• Created on: 2021-11-29 11:47:05