Rituximab plus hyper-CVAD alternating with MTX/Ara-C in patients with newly diagnosed mantle cell lymphoma: 15-year follow-up of a phase II study from the MD Anderson Cancer Center Journal Article
| Authors: | Chihara, D.; Cheah, C. Y.; Westin, J. R.; Fayad, L. E.; Rodriguez, M. A.; Hagemeister, F. B.; Pro, B.; McLaughlin, P.; Younes, A.; Samaniego, F.; Goy, A.; Cabanillas, F.; Kantarjian, H.; Kwak, L. W.; Wang, M. L.; Romaguera, J. E. |
| Article Title: | Rituximab plus hyper-CVAD alternating with MTX/Ara-C in patients with newly diagnosed mantle cell lymphoma: 15-year follow-up of a phase II study from the MD Anderson Cancer Center |
| Abstract: | Intensive chemotherapy regimens containing cytarabine have substantially improved remission durability and overall survival in younger adults with mantle cell lymphoma (MCL). However, there have been no long-term follow-up results for patients treated with these regimens. We present long-term survival outcomes from a pivotal phase II trial of rituximab, hyper-fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with methotrexate and cytarabine (R-HCVAD/MA). At 15 years of follow-up (median: 13·4 years), the median failure-free survival (FFS) and overall survival (OS) for all patients was 4·8 years and 10·7 years, respectively. The FFS seems to have plateaued after 10 years, with an estimated 15-year FFS of 30% in younger patients (≤65 years). Patients who achieved complete response (CR) after 2 cycles had a favourable median FFS of 8·8 years. Six patients developed myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML) whilst in first CR. The 10-year cumulative incidence of MDS/AML of patients in first remission was 6·2% (95% confidence interval: 2·5-12·2%). In patients with newly diagnosed MCL, R-HCVAD/MA showed sustained efficacy, with a median OS exceeding 10 years in all patients and freedom from disease recurrence of nearly 15 years in almost one-third of the younger patients (≤65 years). © 2016 John Wiley & Sons Ltd. |
| Keywords: | adult; cancer survival; aged; major clinical study; overall survival; cancer recurrence; doxorubicin; cancer growth; cancer risk; drug efficacy; drug withdrawal; unspecified side effect; treatment; cytarabine; methotrexate; rituximab; follow up; cancer incidence; mantle cell lymphoma; multiple cycle treatment; phase 2 clinical trial; cyclophosphamide; dexamethasone; vincristine; risk factor; cancer regression; albumin; myelodysplastic syndrome; splenomegaly; drug response; acute myeloblastic leukemia; lactate dehydrogenase; beta 2 microglobulin; age distribution; secondary malignancy; albumin blood level; hyper-cvad; failure free survival; lymphoblastoid cell; cancer prognosis; long term survival; very elderly; human; male; female; priority journal; article |
| Journal Title: | British Journal of Haematology |
| Volume: | 172 |
| Issue: | 1 |
| ISSN: | 0007-1048 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2016-01-01 |
| Start Page: | 80 |
| End Page: | 88 |
| Language: | English |
| DOI: | 10.1111/bjh.13796 |
| PROVIDER: | scopus |
| PUBMED: | 26648336 |
| PMCID: | PMC5471614 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 March 2016 -- Source: Scopus |
