Outcomes For MCL Patients and Impact of Relapse Timing After Transplant on OS

Peter Riedell, MD, an assistant professor of medicine at University of Chicago Medicine, discusses outcomes for mantle cell lymphoma patients and the impact of the timing of relapse on overall survival after autologous stem cell transplantation.

Peter Riedell, MD, an assistant professor of medicine at University of Chicago Medicine, discusses outcomes for mantle cell lymphoma (MCL) patients and the impact of the timing of relapse on overall survival (OS) after autologous stem cell transplantation.

According to Riedell, MCL is generally uncommon, and outcomes can be heterogenous. Currently, the standard of care in young and fit patients is a rituximab (Rituxan) and cytarabine-containing regimen followed by autologous stem cell transplant. Generally, patients have favorable outcomes with this approach, according to Riedell.

In a retrospective analysis conducted by Riedell and a team of investigators, the 5-year progression-free survival of this population is close to 45%, with a 5-year OS of 70%. However, according to Riedell, for patients that relapse early after transplant, outcomes tend to be much poorer. This is especially true for patients who relapse at 18 months or less following transplant. 

0:08 | Mantle cell lymphoma is an uncommon subtype of B-cell non-Hodgkin lymphoma, and overall, outcomes can be very heterogeneous. In young and fit patients, 1 of the standard treatment paradigms would be utilization of upfront rituximab and cytarabine-containing induction regimen followed by consolidative autologous stem cell transplant. And in general, the outcomes are favorable with that treatment approach. In our study, we demonstrated findings including a 5-year progression-free survival of close to about 45%, with a 5-year overall survival close to about 70%. One of the things to note though, is there is a population of patients that do relapse early, and we specifically wanted to focus on that population of patients to evaluate their outcomes, and the impact of early relapse in that population of patients undergoing an upfront transplant. Through a dynamic landmark we were able to look at relapse at different time points, and we specifically noted in our analysis that patients that relapse by the 6-, 12-, and 18-month landmark time points following auto transplant had very poor outcomes overall.