title: Potential prolongation of PFS in mantle cell lymphoma after R-HyperCVAD: auto-SCT consolidation or rituximab maintenance.
abstract: We retrospectively analyzed 44 patients undergoing first-line treatment for mantle cell lymphoma with R-HyperCVAD, with or without rituximab (R) maintenance or auto-SCT. The primary study end point was PFS; secondary end point was overall survival.Median follow up for all patients was 3.3 years. Median age was 54 years, and 95% (n=42) were stage III or IV at diagnosis. In all, 17 patients underwent consolidative auto-SCT and 12 patients received R maintenance. The overall response rate was 95%, with 91% achieving complete response (CR). Median PFS for all patients was 3.5 years. Median PFS was 2.3 years for patients treated with R-HyperCVAD alone vs 3.9 years (P=0.02) with R-HyperCVAD+ R maintenance and 4.5 years (P=0.01) with R-HyperCVAD+ auto-SCT. For patients who did not achieve CR at interim staging, PFS for R-HyperCVAD alone was 1.4 years vs not reached for R-HyperCVAD+ consolidation (either R maintenance or auto-SCT) (P=0.02). PFS for patients with CR at interim staging was 3.3 years vs not reached (P=0.04) after consolidation. Our data suggest potential improvement in PFS when R-HyperCVAD is consolidated with either R maintenance or auto-SCT. This benefit appears particularly significant in those patients who do not achieve CR at interim restaging.
authors.affiliation: Division of Hematology/Oncology, Abramson Cancer Center, University of Pennsylvania, 34th and Spruce Street, Philadelphia, PA 19104, USA. Tahamtan.ahmadi@uphs.upenn.edu
authors.forename: T
authors.initials: T
authors.lastname: Ahmadi
authors.forename: J
authors.initials: J
authors.lastname: McQuade
authors.forename: D
authors.initials: D
authors.lastname: Porter
authors.forename: N
authors.initials: N
authors.lastname: Frey
authors.forename: A W
authors.initials: AW
authors.lastname: Loren
authors.forename: S C
authors.initials: SC
authors.lastname: Goldstein
authors.forename: J
authors.initials: J
authors.lastname: Svoboda
authors.forename: E
authors.initials: E
authors.lastname: Stadtmauer
authors.forename: S J
authors.initials: SJ
authors.lastname: Schuster
authors.forename: S D
authors.initials: SD
authors.lastname: Nasta
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D000069283:Rituximab; D033581:Stem Cell Transplantation; D015996:Survival Rate; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab