A Study at Ash 2024 Found That Early Progression of Disease in Mantle Cell Lymphoma Significantly Worsons Survival, Indicating the Need For A More Nuanced Approach to Risk Stratification.
Mantle Cell Lymphoma (MCL), Subtype of Non-Hodgkin Lymphoma, is Characterized by Frequent Relapses and Variable Treatment Responses, Explain the Authors of A Recent Study Apped at the Ash 2024 Annual Meeting. Prior Research Has Shown That Progression of Disease (Pod) Within 24 months is linked to poor prognosis, Yet comparisons Between Patients with pod and thhose who remain progression-free (PF) have been limited, They Said.
“It has Been Established That (Pod) Within 24 Months In Patients (with MCL) is Associated with Poor Proncosis. However, comparisons with (PF) Patients Are Scarce, and the Cut-off at 24 Months Potentially Oversimplifies A More Complex Patient Tractory, ”The Authors Noted.
For Their Population-Based Study, The Authors Souht to Refine The Understanding of Disease Progression By Analyzing the Impact of Pod Timing on Overall Survival (OS) Following First-Line Therapy.
The Study Included 1,185 Patients with MCl Diagnosed from 2006 to 2018 Who Received Systemic First-Line Treatment. Patients Were Classified as Experiencing Pod IF Had Had Progressive Disease As Their Best Response To Therapy or Related After An Initial Response. Those who have not Yet Met these Creteria Were Consreded PF. The Analysis Used Cox Proportional Hazard Models with Pod as Time-Varying Covariate and an Illness-Deate Model to Evaluate Cumulaative Progression Risk and Conditional 5-Year Os.
Among the Cohort, 33% Received Bendamustine-Rituximab (BR), 30% Received Nordic MCL2 (Dose-Scaled R-Chop Alternating with R-Cytarabine Folloowed by AutoLogs Stem Cell Transplantation), and 14% Received R-Chop or a similar regime . The MediaN Age was Highest for B (75 years) and Lowest for Nordic MCL2 (62 years). Nearly Half of the Patients (48%) Experienced Pod, with 12% Progressing Imbialyly After First-Line Therapy. The cumulaative 5-type risk for pod was 44% for br, 39% for nordic mcl2, and 51% for r-chop.
POD WAS ASSOCIATED WITH SIGNENTLY INCREASED MORTALITY ACROSS ALL TREATMENT GROUPS. The Adjustped Hazard Ratio (HR) for All-Cause Mortality in Pod versus PF Patients Was 7.45. Early Progression (<12 months) Had the Most Severe Impact, Particularly in Nordic MCL2-Treated Patients (HR = 34.2). The 5-year OS for br-treated patients with pod at one year just 4.7%, compared to 50% if they remained pf. Similarly, the Was Markedly Reduced for Early Pod in Nordic MCL2 (14% vs 74%) and R-Chop (13% vs 48%).
“Taken Together, Pod is Associated with Worse Outcomes Regardless of When it Occurs, Although Very Early Pod is specially Serious,” The Authors Wrote.
Even Beyond 24 months, pod was associated with poor survival outcomes, Underscoring the inadequacy of a fixed 24-month threshold for risk strutification.
“This Underlines The Importance of Not Limiting to a Dichotomized Comparison (<24 /> 24 months) When Studying Patienti and eligibility for New Treatments Within or Outside Clinical Trials,” The Authors Noted. “The Comparison of Survival Beteen Patients with pod and thhose who remain pf Incorporating the Full Patient Pathway Over A Continuous Timescale Adds Further Nuance to Our Undersease of the Disease Course.”
Future Research Should Focus on Identifying Factors Influenced Pod and OS Refine Treatment Strategies and Enhance Patient Survival.
