title: Long-term clinical and molecular remissions in patients with mantle cell lymphoma following high-dose therapy and autologous stem cell transplantation.
abstract: Long-term clinical and molecular remissions in patients with mantle cell lymphoma (MCL) following high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) have been evaluated in only a few studies. Thirty-six patients with MCL received ASCT in our institution (27 patients undergoing first-line therapy, 8 patients undergoing second-line therapy, and 1 patient undergoing third-line therapy). In the case of long-term remission (≥5 years; n = 8), peripheral blood was tested for minimal residual disease (MRD) by t(11; 14) polymerase chain reaction (PCR) and immunoglobulin heavy-chain (IGH) PCR at the last follow-up. Ten-year overall survival (OS), progression-free survival (PFS), and freedom from progression (FFP) after first-line ASCT were 42 %, 43 %, and 54 %; after second-line ASCT, these were all 0 %. Four-year OS, PFS, and FFP for the first-line cohort were 75 %, 48 %, and 61 %, respectively. Four-year OS, PFS, and FFP after second-line ASCT were 55 %, 30 %, and 30 %, respectively. Treatment-related mortality (3 months after ASCT) was 0 %. The only prognostic factor for OS, PFS, and FFP was treatment line (p = 0.011, p = 0.046, and p = 0.023, respectively). No relapses occurred after 5 years following ASCT. So far, eight patients developed sustained long-term clinical and molecular complete remissions of up to 14.6 years following ASCT in the first treatment line. Sustained long-term clinical and molecular remissions can be achieved following ASCT in the first treatment line and apparently less frequent in the second treatment line.
authors: Department of Oncology and Hematology, Klinikum Oldenburg, University Clinic, Oldenburg, Germany, metzner.bernd@klinikum-oldenburg.de.
authors: Bernd
authors: B
authors: Metzner
authors: Thomas H
authors: TH
authors: Müller
authors: Wolfgang
authors: W
authors: Gebauer
authors: Jochen
authors: J
authors: Casper
authors: Doris
authors: D
authors: Kraemer
authors: Bernd
authors: B
authors: Rosien
authors: Silke
authors: S
authors: Schumann-Binarsch
authors: Ruth
authors: R
authors: Thole
authors: Claus H
authors: CH
authors: Köhne
authors: Martin
authors: M
authors: Dreyling
authors: Eva
authors: E
authors: Hoster
authors: Christiane
authors: C
authors: Pott
mesh_terms: D000293:Adolescent; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000097:blood; D020522:Lymphoma, Mantle-Cell / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012074:Remission Induction; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007143:Immunoglobulin Heavy Chains