title: Outcomes of both abbreviated hyper-CVAD induction followed by autologous hematopoietic cell transplantation and conventional chemotherapy for mantle cell lymphoma: a 10-year single-centre experience with literature review.
abstract: We retrospectively evaluated consecutive patients diagnosed with Mantle cell lymphoma (MCL) between 01 January 2000 and 31 December 2009. Eighty eight patients with MCL were included in the analysis of whom 46 (52%) received abbreviated Hyper-CVAD (a total of two cycles; with addition of Rituximab since 2005) with an intention of proceeding to autologous hematopoietic cell transplantation (auto-HCT), with a median age of 58 years. Response rate to induction at auto-HCT time was 89% and complete response was 61%. Forty four patients received an auto-HCT with a 5-year progression-free survival (PFS) and overall survival (OS) were 31.2% and 62.5%, respectively. There were 42 nontransplant eligible patients with a median age of 72 years, and 5-year PFS and OS were 0.0% and 39.9%, respectively. The median survival and PFS in the auto-HCT eligible group were 68 and 33 months, compared to 32 and 12 months in nontransplant eligible group, without a plateauing of the survival curves in either group. Treatment-related mortality in the auto-HCT eligible group was 10.9% (n = 5); two patients died during R-Hyper-CVAD and 3 (6.8%) experienced transplant-related mortality. An abbreviated R-Hyper-CVAD-based induction strategy followed by consolidative auto-HCT is feasible and provides moderate potential of long-term survival. Further research to define risk-adapted strategies; to optimize disease control, is required.
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|College of Medicine at Taibah University, Almadinah Almunawarh, Saudi Arabia.
authors.forename: Turki Abdulaziz
authors.initials: TA
authors.lastname: Alwasaidi
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Department of Medical Oncology, Cancer Center, Kuwait, Kuwait.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Hamadah
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.
authors.forename: Sultan
authors.initials: S
authors.lastname: Altouri
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.
authors.forename: Sheryl
authors.initials: S
authors.lastname: McDiarmid
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Faught
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Allan
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Lothar
authors.initials: L
authors.lastname: Huebsch
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bredeson
authors.affiliation: Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bence-Bruckler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide
keywords: Autologous hematopoietic cell transplantation; conventional chemotherapy; mantle cell lymphoma; nontransplant eligible