Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era

Reem Karmali; Jeffrey M. Switchenko; Subir Goyal; Krithika Shanmugasundaram; Michael C. Churnetski; Bhaskar C Kolla; Veronika Bachanova; James N. Gerson; Stefan K. Barta; Max J. Gordon; Alexey V. Danilov; Natalie S. Grover; Narendranath Epperla; Stephanie Mathews; Madelyn Burkart; Yazeed Sawalha; Brian T. Hill; Nilanjan Ghosh; Steven I. Park; David A. Bond; Kami J. Maddocks; Talha Badar; Timothy S. Fenske; Mehdi Hamadani; Jin Guo; Mary Malecek; Brad S. Kahl; Peter Martin; Kristie A. Blum; Christopher R. Flowers; Jonathon B. Cohen

doi:10.1002/ajh.26306

Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era

Reem Karmali, Jeffrey M. Switchenko, Subir Goyal, Krithika Shanmugasundaram, Michael C. Churnetski, Bhaskar C Kolla, Veronika Bachanova, James N. Gerson, Stefan K. Barta, Max J. Gordon, Alexey V. Danilov, Natalie S. Grover, Narendranath Epperla, Stephanie Mathews, Madelyn Burkart, Yazeed Sawalha, Brian T. Hill, Nilanjan Ghosh, Steven I. Park, David A. BondKami J. Maddocks, Talha Badar, Timothy S. Fenske, Mehdi Hamadani, Jin Guo, Mary Malecek, Brad S. Kahl, Peter Martin, Kristie A. Blum, Christopher R. Flowers, Jonathon B. Cohen

Medicine - Hematology, Oncology, Transplant

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Clinical outcomes and predictors of survival in patients with newly diagnosed mantle cell lymphoma (MCL) treated in the rituximab era (2000–2015) at 12 US academic centers were assessed to identify determinants of survival across age groups. Objectives were to characterize and compare practice patterns, outcomes and prognostic factors for survival in younger patients (age < 65) and older patients (age ≥ 65 years). Among 1162 patients included, 697 were younger and 465 were older. In younger patients, 2-year progression free survival (PFS) and overall survival (OS) rates were 79% and 92% respectively; blastoid histology, ECOG ≥ 2, and lack of maintenance rituximab (MR) remained statistically relevant to poor OS on univariate analysis (UVA) and multivariate analysis (MVA). In older patients, 2-year PFS and OS rates were 67% and 86% respectively; lack of maintenance rituximab remained significantly associated with inferior PFS and OS on UVA and MVA (p < 0.001). Two-year PFS rates were 79%, and 67% and 2-year OS rates were 92% and 86% for ages < 65 and ≥ 65 respectively (p < 0.001). First-line high-dose cytarabine exposure and/or MR lessened the negative impact of age on survival. Taken collectively, survival outcomes for older patients remain inferior to those of younger patients in the rituximab era. However, maintenance rituximab and potentially high-dose cytarabine-based induction can mitigate the negative impact of age on survival.

Original language	English (US)
Pages (from-to)	1374-1384
Number of pages	11
Journal	American Journal of Hematology
Volume	96
Issue number	11
DOIs	https://doi.org/10.1002/ajh.26306
State	Published - Nov 1 2021

Bibliographical note

Funding Information:
C.F. has received research from 4D, Abbvie, Acerta, Adaptimmune, Allogene, Amgen, Bayer, Celgene, Cellectis, EMD, Gilead, Genentech/Roche, Guardant, Iovance, Janssen Pharmaceutical, Kite, Morphosys, Nektar, Novartis, Pfizer, Pharmacyclics, Sanofi, Takeda, TG Therapeutics, Xencor, Ziopharm, Burroughs Wellcome Fund, Eastern Cooperative Oncology Group, National Cancer Institute, V Foundation, Cancer Prevention and Research Institute of Texas: CPRIT Scholar in Cancer Research. CF has consulted for Abbvie, Bayer, BeiGene, Celgene, Denovo Biopharma, Genentech/Roche, Gilead, Karyopharm, Pharmacyclics/ Janssen, Spectrum.

Funding Information:
K.M. has received research funding from Pharmacyclics, BMS, Merck, Novartis. K.M. has consulted for Pharmacyclics, Janssen, Morphosys, Celgene, Beigene, Kite, Karyopharm, ADC Therapeutics, Seattle Genetics.

Publisher Copyright:
© 2021 Wiley Periodicals LLC.

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Karmali, R., Switchenko, J. M., Goyal, S., Shanmugasundaram, K., Churnetski, M. C., Kolla, B. C., Bachanova, V., Gerson, J. N., Barta, S. K., Gordon, M. J., Danilov, A. V., Grover, N. S., Epperla, N., Mathews, S., Burkart, M., Sawalha, Y., Hill, B. T., Ghosh, N., Park, S. I., ... Cohen, J. B. (2021). Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era. American Journal of Hematology, 96(11), 1374-1384. https://doi.org/10.1002/ajh.26306

Karmali, R, Switchenko, JM, Goyal, S, Shanmugasundaram, K, Churnetski, MC, Kolla, BC, Bachanova, V, Gerson, JN, Barta, SK, Gordon, MJ, Danilov, AV, Grover, NS, Epperla, N, Mathews, S, Burkart, M, Sawalha, Y, Hill, BT, Ghosh, N, Park, SI, Bond, DA, Maddocks, KJ, Badar, T, Fenske, TS, Hamadani, M, Guo, J, Malecek, M, Kahl, BS, Martin, P, Blum, KA, Flowers, CR & Cohen, JB 2021, 'Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era', American Journal of Hematology, vol. 96, no. 11, pp. 1374-1384. https://doi.org/10.1002/ajh.26306

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abstract = "Clinical outcomes and predictors of survival in patients with newly diagnosed mantle cell lymphoma (MCL) treated in the rituximab era (2000–2015) at 12 US academic centers were assessed to identify determinants of survival across age groups. Objectives were to characterize and compare practice patterns, outcomes and prognostic factors for survival in younger patients (age < 65) and older patients (age ≥ 65 years). Among 1162 patients included, 697 were younger and 465 were older. In younger patients, 2-year progression free survival (PFS) and overall survival (OS) rates were 79% and 92% respectively; blastoid histology, ECOG ≥ 2, and lack of maintenance rituximab (MR) remained statistically relevant to poor OS on univariate analysis (UVA) and multivariate analysis (MVA). In older patients, 2-year PFS and OS rates were 67% and 86% respectively; lack of maintenance rituximab remained significantly associated with inferior PFS and OS on UVA and MVA (p < 0.001). Two-year PFS rates were 79%, and 67% and 2-year OS rates were 92% and 86% for ages < 65 and ≥ 65 respectively (p < 0.001). First-line high-dose cytarabine exposure and/or MR lessened the negative impact of age on survival. Taken collectively, survival outcomes for older patients remain inferior to those of younger patients in the rituximab era. However, maintenance rituximab and potentially high-dose cytarabine-based induction can mitigate the negative impact of age on survival.",

author = "Reem Karmali and Switchenko, {Jeffrey M.} and Subir Goyal and Krithika Shanmugasundaram and Churnetski, {Michael C.} and Kolla, {Bhaskar C} and Veronika Bachanova and Gerson, {James N.} and Barta, {Stefan K.} and Gordon, {Max J.} and Danilov, {Alexey V.} and Grover, {Natalie S.} and Narendranath Epperla and Stephanie Mathews and Madelyn Burkart and Yazeed Sawalha and Hill, {Brian T.} and Nilanjan Ghosh and Park, {Steven I.} and Bond, {David A.} and Maddocks, {Kami J.} and Talha Badar and Fenske, {Timothy S.} and Mehdi Hamadani and Jin Guo and Mary Malecek and Kahl, {Brad S.} and Peter Martin and Blum, {Kristie A.} and Flowers, {Christopher R.} and Cohen, {Jonathon B.}",

note = "Funding Information: C.F. has received research from 4D, Abbvie, Acerta, Adaptimmune, Allogene, Amgen, Bayer, Celgene, Cellectis, EMD, Gilead, Genentech/Roche, Guardant, Iovance, Janssen Pharmaceutical, Kite, Morphosys, Nektar, Novartis, Pfizer, Pharmacyclics, Sanofi, Takeda, TG Therapeutics, Xencor, Ziopharm, Burroughs Wellcome Fund, Eastern Cooperative Oncology Group, National Cancer Institute, V Foundation, Cancer Prevention and Research Institute of Texas: CPRIT Scholar in Cancer Research. CF has consulted for Abbvie, Bayer, BeiGene, Celgene, Denovo Biopharma, Genentech/Roche, Gilead, Karyopharm, Pharmacyclics/ Janssen, Spectrum. Funding Information: K.M. has received research funding from Pharmacyclics, BMS, Merck, Novartis. K.M. has consulted for Pharmacyclics, Janssen, Morphosys, Celgene, Beigene, Kite, Karyopharm, ADC Therapeutics, Seattle Genetics. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC.",

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AU - Karmali, Reem

AU - Switchenko, Jeffrey M.

AU - Goyal, Subir

AU - Shanmugasundaram, Krithika

AU - Churnetski, Michael C.

AU - Kolla, Bhaskar C

AU - Bachanova, Veronika

AU - Gerson, James N.

AU - Barta, Stefan K.

AU - Gordon, Max J.

AU - Danilov, Alexey V.

AU - Grover, Natalie S.

AU - Epperla, Narendranath

AU - Mathews, Stephanie

AU - Burkart, Madelyn

AU - Sawalha, Yazeed

AU - Hill, Brian T.

AU - Ghosh, Nilanjan

AU - Park, Steven I.

AU - Bond, David A.

AU - Maddocks, Kami J.

AU - Badar, Talha

AU - Fenske, Timothy S.

AU - Hamadani, Mehdi

AU - Guo, Jin

AU - Malecek, Mary

AU - Kahl, Brad S.

AU - Martin, Peter

AU - Blum, Kristie A.

AU - Flowers, Christopher R.

AU - Cohen, Jonathon B.

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PY - 2021/11/1

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N2 - Clinical outcomes and predictors of survival in patients with newly diagnosed mantle cell lymphoma (MCL) treated in the rituximab era (2000–2015) at 12 US academic centers were assessed to identify determinants of survival across age groups. Objectives were to characterize and compare practice patterns, outcomes and prognostic factors for survival in younger patients (age < 65) and older patients (age ≥ 65 years). Among 1162 patients included, 697 were younger and 465 were older. In younger patients, 2-year progression free survival (PFS) and overall survival (OS) rates were 79% and 92% respectively; blastoid histology, ECOG ≥ 2, and lack of maintenance rituximab (MR) remained statistically relevant to poor OS on univariate analysis (UVA) and multivariate analysis (MVA). In older patients, 2-year PFS and OS rates were 67% and 86% respectively; lack of maintenance rituximab remained significantly associated with inferior PFS and OS on UVA and MVA (p < 0.001). Two-year PFS rates were 79%, and 67% and 2-year OS rates were 92% and 86% for ages < 65 and ≥ 65 respectively (p < 0.001). First-line high-dose cytarabine exposure and/or MR lessened the negative impact of age on survival. Taken collectively, survival outcomes for older patients remain inferior to those of younger patients in the rituximab era. However, maintenance rituximab and potentially high-dose cytarabine-based induction can mitigate the negative impact of age on survival.

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Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era

Abstract

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