In a retrospective study reported in the Journal of Clinical Oncology, Gerson et al found evidence that autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy was associated with a progression-free survival benefit in patients with mantle cell lymphoma aged ≤ 65 years treated in the rituximab era. The investigators noted that whereas AHCT consolidation is often used in eligible patients, its benefit remains uncertain in the era of rituximab-containing induction therapy.
The study involved data on 1,029 transplantation-eligible patients aged ≤ 65 years with newly diagnosed mantle cell lymphoma treated between 2000 and 2015 at 25 North American medical centers.
The primary objective was to assess for improved progression-free survival with AHCT consolidation; assessing for improved overall survival was a secondary objective. Data were evaluated using Cox multivariable regression analysis and propensity score–weighted (PSW) analysis.
Progression-Free and Overall Survival
Median follow-up for the entire cohort was 76 months. Median progression-free survival and overall survival were 62 and 139 months. Overall, 64% of patients received AHCT consolidation after induction. On unadjusted analysis, AHCT vs no AHCT was associated with improved progression-free survival (median = 75 vs 44 months, P < .01) and overall survival (147 vs 115 months, P < .05).
On multivariate analysis, AHCT was associated with improved progression-free survival (hazard ratio [HR] = 0.54, P < .01) and a trend toward improved overall survival (HR = 0.77, P = .06). On PSW analysis, AHCT was associated with improved progression-free survival (HR = 0.70, P < .05) but not improved overall survival (HR = 0.87, P = .2).
The authors concluded,“In this large cohort of younger, transplantation-eligible patients with mantle cell lymphoma, AHCT consolidation after induction was associated with significantly improved [progression-free survival] but not [overall survival] after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve [progression-free survival].”
Stefan K. Barta, MD, of the University of Pennsylvania, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study authors’ full disclosures can be found at jco.ascopubs.org.
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