title: Specific features identify patients with relapsed or refractory mantle cell lymphoma benefitting from autologous hematopoietic cell transplantation.
abstract: Outcomes with autologous hematopoietic cell transplantation (auto HCT) for relapsed and/or refractory mantle cell lymphoma (MCL) are typically poor. We hypothesized that certain factors could predict which patients experience a favorable outcome with this approach. We thus developed a predictive score from a cohort of 67 such patients using 3 factors independently associated with progression-free survival (PFS): (1) simplified Mantle Cell Lymphoma International Prognostic Index score before auto HCT (hazard ratio [HR], 2.9; P = .002); (2) B symptoms at diagnosis (HR, 2.7; P = .005); and (3) remission quotient, calculated by dividing the time, in months, from diagnosis to auto HCT by the number of prior treatments (HR, 1.4; P = .02). The estimated 5-year PFS for favorable-risk patients (n = 23) and unfavorable-risk patients (n = 44) were 58% (95% confidence interval [CI], 34% to 75%) and 15% (95% CI, 6% to 28%), respectively. These factors also independently predicted overall survival. In summary, we have defined 3 simple factors that can identify patients with relapsed/refractory MCL who derive a durable benefit from salvage auto HCT.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Cassaday
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Guthrie
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Budde
authors.forename: Leslie
authors.initials: L
authors.lastname: Thompson
authors.forename: Brian G
authors.initials: BG
authors.lastname: Till
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Press
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Chauncey
authors.forename: John M
authors.initials: JM
authors.lastname: Pagel
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Petersdorf
authors.forename: Maria Corinna
authors.initials: MC
authors.lastname: Palanca-Wessels
authors.forename: Mary
authors.initials: M
authors.lastname: Philip
authors.forename: William I
authors.initials: WI
authors.lastname: Bensinger
authors.forename: Leona A
authors.initials: LA
authors.lastname: Holmberg
authors.forename: Andrei
authors.initials: A
authors.lastname: Shustov
authors.forename: Damian J
authors.initials: DJ
authors.lastname: Green
authors.forename: Edward N
authors.initials: EN
authors.lastname: Libby
authors.forename: David G
authors.initials: DG
authors.lastname: Maloney
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Gopal
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012074:Remission Induction; D014182:Transplantation, Autologous
keywords: Autologous transplantation; Mantle cell lymphoma