title: Improvement of overall survival in advanced stage mantle cell lymphoma.
abstract: OBJECTIVE
  Mantle cell lymphomas (MCLs) represent a clinically aggressive lymphoma subtype with a poor prognosis. To explore a potential progress in outcome a historical comparison was performed using data from the Kiel Lymphoma Study Group (KLSG; 1975 to 1986) and the German Low Grade Lymphoma Study Group (GLSG; 1996 to 2004).
  
  
  METHODS
  All patients with the histologically confirmed diagnosis of advanced-stage nonblastoid MCL were eligible. To minimize the potential heterogeneity of different risk profiles frequency matching was pursued. In addition, we adjusted for potential confounding variables by multiple Cox regression.
  
  
  RESULTS
  A total of 520 patients were assessable, 150 from KLSG and 370 from GLSG studies. The median overall survival was 2.7 years for KLSG patients as compared with 4.8 years for GLSG patients (P < .0001). The 5-year survival rates were 22% in the KLSG group (95% CI, 13% to 31%) as compared with 47% for GLSG treated patients (95% CI, 38% to 55%). The hazard ratio adjusted for performance status, lactate dehydrogenase, and age was 0.44 for GLSG patients (95% CI, 0.32 to 0.59).
  
  
  CONCLUSIONS
  Median overall survival of patients with advanced nonblastoid MCL almost doubled during the past 30 years. Potential reasons for this apparent improvement in overall survival include the application of anthracycline-containing regimens and new approaches, such as antilymphoma antibodies or stem cell transplantation. Advances in general supportive care, new diagnostic tools, and general improvement of life span might have also reinforced this effect. However, our results are questioning the validity of historical comparisons which had been frequently applied in previous trials.
authors.affiliation: Department of Internal Medicine III, University of Munich, Germany.
authors.forename: Annina
authors.initials: A
authors.lastname: Herrmann
authors.forename: Eva
authors.initials: E
authors.lastname: Hoster
authors.forename: Thomas
authors.initials: T
authors.lastname: Zwingers
authors.forename: Günter
authors.initials: G
authors.lastname: Brittinger
authors.forename: Marianne
authors.initials: M
authors.lastname: Engelhard
authors.forename: Peter
authors.initials: P
authors.lastname: Meusers
authors.forename: Marcel
authors.initials: M
authors.lastname: Reiser
authors.forename: Roswitha
authors.initials: R
authors.lastname: Forstpointner
authors.forename: Bernd
authors.initials: B
authors.lastname: Metzner
authors.forename: Norma
authors.initials: N
authors.lastname: Peter
authors.forename: Bernhard
authors.initials: B
authors.lastname: Wörmann
authors.forename: Lorenz
authors.initials: L
authors.lastname: Trümper
authors.forename: Michael
authors.initials: M
authors.lastname: Pfreundschuh
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hiddemann
authors.forename: Michael
authors.initials: M
authors.lastname: Unterhalt
authors.forename: Martin
authors.initials: M
authors.lastname: Dreyling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015996:Survival Rate