Bendamustine or high-dose cytarabine-based induction with rituximab in transplant-eligible mantle cell lymphoma.
Bendamustine or high-dose cytarabine-based induction with rituximab in transplant-eligible mantle cell lymphoma.
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DOI：
10.1182/bloodadvances.2022007371
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发表时间：
2022-09-27
期刊：
影响因子：
7.5
通讯作者：
Dreyling, Martin
中科院分区：
文献类型：
--
作者：
Villa, Diego;Hoster, Eva;Hermine, Olivier;Klapper, Wolfram;Szymczyk, Michal;Bosly, Andre;Unterhalt, Michael;Rimsza, Lisa M.;Ramsower, Colleen A.;Freeman, Ciara L.;Scott, David W.;Gerrie, Alina S.;Savage, Kerry J.;Sehn, Laurie H.;Dreyling, Martin
R-B联合ASCT和MR是年轻、符合移植条件的MCL患者可行的一线策略。R-B联合ASCT和MR的结局与R-CHOP/R-DHAP联合ASCT相当。本研究的目的是探讨一线利妥昔单抗联合苯达莫司汀（R-B）和R-CHOP/R-DHAP（利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松、地塞米松、阿糖胞苷、顺铂）治疗符合移植条件的套细胞淋巴瘤（MCL）患者的结局差异。在BC Cancer回顾性确定了一个基于人群的队列，包括97例年龄在18至65岁之间的II-IV期MCL患者，连续接受R-B治疗。将基线特征、缓解率和结局与随机分配至MCL Younger试验的R-CHOP/R-DHAP组的232例MCL患者队列进行比较。主要终点是两组之间无进展生存期（PFS）比较的风险比（HR），校正MCL国际预后指数（MIPI）、Ki 67指数和胚样/多形性形态。两组之间的安阿伯分期、乳酸脱氢酶、MIPI、胚样形态和MCL 35分配相似。R-B的总体缓解率（ORR）为90%（54%完全缓解[CR]）; 77%的患者进行自体干细胞移植（ASCT），78%的患者接受利妥昔单抗（MR）维持治疗。R-CHOP/R-DHAP的ORR为94%（54% CR）; 78%进行ASCT，2%接受MR。未校正（HR，0.87; 95%置信区间[CI]，0.53-1.41; P = 0.56）或校正（HR，0.79; 95% CI，0.45-1.37; P = 0.40）比较的PFS无差异。在未校正或校正分析中，次要终点无明显差异。对2个独立队列的年轻MCL患者进行的回顾性调整比较表明，R-B联合ASCT和利妥昔单抗维持治疗是一种可行且有效的一线治疗，其结局与R-CHOP/R-DHAP联合ASCT相当。
R-B with ASCT and MR is a feasible first-line strategy for younger, transplant-eligible patients with MCL. R-B with ASCT and MR achieves outcomes comparable to R-CHOP/R-DHAP with ASCT. The objective of this study was to explore differences in outcomes between first-line rituximab plus bendamustine (R-B) and R-CHOP/R-DHAP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone, dexamethasone, cytarabine, cisplatin) in transplant-eligible patients with mantle cell lymphoma (MCL). A population-based cohort of 97 patients aged 18 to 65 years with stage II-IV MCL, consecutively treated with R-B was retrospectively identified at BC Cancer. Baseline characteristics, response rates, and outcomes were compared with the cohort of 232 patients with MCL randomized to the R-CHOP/R-DHAP arm of the MCL Younger trial. The primary endpoint was the hazard ratio (HR) of the progression-free survival (PFS) comparison between both groups, adjusted for MCL International Prognostic Index (MIPI), Ki67 index, and blastoid/ pleomorphic morphology. Ann Arbor stage, lactate dehydrogenase, MIPI, blastoid morphology, and MCL35 assignments were similar between both groups. The overall response rate (ORR) to R-B was 90% (54% complete response [CR]); 77% of patients proceeded to autologous stem cell transplantation (ASCT) and 78% received maintenance rituximab (MR). The ORR to R-CHOP/R-DHAP was 94% (54% CR); 78% proceeded to ASCT and 2% received MR. There were no differences in PFS in unadjusted (HR, 0.87; 95% confidence interval [CI], 0.53-1.41; P = .56) or adjusted (HR, 0.79; 95% CI, 0.45-1.37; P = .40) comparisons. There were no clear differences in secondary endpoints in unadjusted or adjusted analyses. This retrospective adjusted comparison of 2 independent cohorts of younger patients with MCL suggests that R-B with ASCT and maintenance rituximab is a feasible and effective first-line treatment, with outcomes comparable to R-CHOP/R-DHAP with ASCT.
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影响因子：
6.5
作者：
Eskelund, Christian W.;Kolstad, Arne;Geisler, Christian H.
通讯作者：
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168.9
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Hermine, Olivier;Hoster, Eva;Dreyling, Martin
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