title: Cytarabine, Ki-67, and SOX11 in patients with mantle cell lymphoma receiving rituximab-containing autologous stem cell transplantation during first remission.
abstract: BACKGROUND
  In the current study, the authors report the results of 39 patients with mantle cell lymphoma (MCL) who were treated with chemotherapy and high-dose rituximab-containing autologous stem cell transplantation (ASCT) during their first disease remission.
  
  
  METHODS
  The median age of the patients was 54 years. At the time of diagnosis, 87% of patients had Ann Arbor stage IV disease, and 77% had bone marrow involvement. A Ki-67 level of > 30% was found in 11 of 27 patients (40%), and SOX11 (SRY [sex determining region Y)-box 11] expression was found to be positive in 17 of 18 patients (94%). Twenty-seven patients (69%) underwent induction therapy with high-dose cytarabine-containing chemotherapy. Rituximab was administered during stem cell collection at a dose of 1000 mg/m2 on days +1 and +8 after ASCT.
  
  
  RESULTS
  The estimated 4-year overall survival and progression-free survival rates were 82% and 59%, respectively. Twelve patients experienced disease recurrence. Fifteen of 16 patients who were alive and in complete remission at 36 months remained so at a median follow-up of 69 months (range, 38 months-145 months). The only determinant of recurrence risk found was a Ki-67 level of > 30%. Seven of 11 patients with a Ki-67 level > 30% experienced disease recurrence within the first 3 years versus only 3 of 16 patients with a Ki-67 level ≤ 30% (P = .02). Patients who received high-dose cytarabine did not have a significantly different risk of developing disease recurrence compared with other patients (P = .7).
  
  
  CONCLUSIONS
  Administering ASCT with rituximab during stem cell collection and immediately after transplantation may induce a continuous long-term disease remission in patients with MCL with a Ki-67 level of ≤ 30%.
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Zaher I
authors.initials: ZI
authors.lastname: Chakhachiro
authors.forename: Rima M
authors.initials: RM
authors.lastname: Saliba
authors.forename: Grace-Julia
authors.initials: GJ
authors.lastname: Okoroji
authors.forename: Martin
authors.initials: M
authors.lastname: Korbling
authors.forename: Amin M
authors.initials: AM
authors.lastname: Alousi
authors.forename: Oran
authors.initials: O
authors.lastname: Betul
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Ciurea
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.forename: Richard
authors.initials: R
authors.lastname: Champlin
authors.forename: Barry I
authors.initials: BI
authors.lastname: Samuels
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
authors.forename: Carlos
authors.initials: C
authors.lastname: Bueso-Ramos
authors.forename: Issa F
authors.initials: IF
authors.lastname: Khouri
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D000069283:Rituximab; D055751:SOXC Transcription Factors / Q000378:metabolism*; D033581:Stem Cell Transplantation / Q000379:methods*; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019394:Ki-67 Antigen; C097473:SOX11 protein, human; D055751:SOXC Transcription Factors; D003561:Cytarabine; D000069283:Rituximab
keywords: Ki-67; SOX11; autologous stem cell transplantation; mantle cell lymphoma