title: Molecular remission is an independent predictor of clinical outcome in patients with mantle cell lymphoma after combined immunochemotherapy: a European MCL intergroup study.
abstract: The prognostic impact of minimal residual disease (MRD) was analyzed in 259 patients with mantle cell lymphoma (MCL) treated within 2 randomized trials of the European MCL Network (MCL Younger and MCL Elderly trial). After rituximab-based induction treatment, 106 of 190 evaluable patients (56%) achieved a molecular remission (MR) based on blood and/or bone marrow (BM) analysis. MR resulted in a significantly improved response duration (RD; 87% vs 61% patients in remission at 2 years, P = .004) and emerged to be an independent prognostic factor for RD (hazard ratio = 0.4, 95% confidence interval, 0.1-0.9, P = .028). MR was highly predictive for prolonged RD independent of clinical response (complete response [CR], complete response unconfirmed [CRu], partial response [PR]; RD at 2 years: 94% in BM MRD-negative CR/CRu and 100% in BM MRD-negative PR, compared with 71% in BM MRD-positive CR/CRu and 51% in BM MRD-positive PR, P = .002). Sustained MR during the postinduction period was predictive for outcome in MCL Younger after autologous stem cell transplantation (ASCT; RD at 2 years 100% vs 65%, P = .001) and during maintenance in MCL Elderly (RD at 2 years: 76% vs 36%, P = .015). ASCT increased the proportion of patients in MR from 55% before high-dose therapy to 72% thereafter. Sequential MRD monitoring is a powerful predictor for treatment outcome in MCL. These trials are registered at www.clinicaltrials.gov as #NCT00209222 and #NCT00209209.
authors.affiliation: Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Pott
authors.forename: Eva
authors.initials: E
authors.lastname: Hoster
authors.forename: Marie-Helene
authors.initials: MH
authors.lastname: Delfau-Larue
authors.forename: Kheira
authors.initials: K
authors.lastname: Beldjord
authors.forename: Sebastian
authors.initials: S
authors.lastname: Böttcher
authors.forename: Vahid
authors.initials: V
authors.lastname: Asnafi
authors.forename: Anne
authors.initials: A
authors.lastname: Plonquet
authors.forename: Reiner
authors.initials: R
authors.lastname: Siebert
authors.forename: Evelyne
authors.initials: E
authors.lastname: Callet-Bauchu
authors.forename: Niels
authors.initials: N
authors.lastname: Andersen
authors.forename: Jacques J M
authors.initials: JJ
authors.lastname: van Dongen
authors.forename: Wolfram
authors.initials: W
authors.lastname: Klapper
authors.forename: Françoise
authors.initials: F
authors.lastname: Berger
authors.forename: Vincent
authors.initials: V
authors.lastname: Ribrag
authors.forename: Achiel L
authors.initials: AL
authors.lastname: van Hoof
authors.forename: Marek
authors.initials: M
authors.lastname: Trneny
authors.forename: Jan
authors.initials: J
authors.lastname: Walewski
authors.forename: Peter
authors.initials: P
authors.lastname: Dreger
authors.forename: Michael
authors.initials: M
authors.lastname: Unterhalt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hiddemann
authors.forename: Michael
authors.initials: M
authors.lastname: Kneba
authors.forename: Hanneke C
authors.initials: HC
authors.lastname: Kluin-Nelemans
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Macintyre
authors.forename: Martin
authors.initials: M
authors.lastname: Dreyling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002469:Cell Separation; D003131:Combined Modality Therapy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D007167:Immunotherapy / Q000379:methods; D020522:Lymphoma, Mantle-Cell / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011878:Radiotherapy; D016896:Treatment Outcome