title: Efficacy of high-dose therapy and hematopoietic stem cell transplantation for mantle cell lymphoma.
abstract: Conventional treatment of mantle cell lymphoma (MCL) yields modest responses and short remissions. We report 30 hematopoietic stem cell transplants (HSCT) for MCL: 13 autologous, 10 allogeneic myeloablative, and 7 nonablative. After a median 1.2 years from diagnosis (range 0.5 to 4.7) and a median of 2 pre-HSCT chemotherapeutic regimens (range 1 to 5), their median age at HSCT was 52 years (range 37 to 67). Eleven patients (41%) were in first remission, 11 (41%) were in second remission, and 7 (25%) had resistant disease. Four died early. Nineteen achieved CR (83%) and 4 PR (17%). With median 2.7 years of follow-up, 5-year overall survival (OS) was 42% (95% CI 11-73%) after autologous versus allogeneic at 49% (95% CI 22-76%). Five-year progression-free survival (PFS) was 31% (95% CI 3-59%) and 50% (95% CI 24-76%) for autologous and allogeneic HSCT, respectively. Fourteen died: 3 from sepsis, 1 acute GVHD, 10 MCL. No autologous transplant-related deaths occurred. Allogeneic transplant-related mortality was 29% (95% CI 6-52%) at 1 and 5 years. HSCT for MCL can yield extended disease control and long-term survival.
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, USA.
authors.forename: Noel
authors.initials: N
authors.lastname: Laudi
authors.forename: Mukta
authors.initials: M
authors.lastname: Arora
authors.forename: Linda
authors.initials: L
authors.lastname: Burns
authors.forename: Philip
authors.initials: P
authors.lastname: McGlave
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Miller
authors.forename: Gerald
authors.initials: G
authors.lastname: Bohac
authors.forename: Tyson
authors.initials: T
authors.lastname: Rogers
authors.forename: Juliet
authors.initials: J
authors.lastname: Barker
authors.forename: James
authors.initials: J
authors.lastname: Coad
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisdorf
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous