PURPOSE: Treatment of mantle-cell lymphoma (MCL) is nonstandardized, though patients are commonly treated immediately at diagnosis. Because data on observation, or "watch and wait," have not been previously reported, we analyzed the outcome of deferred initial therapy. PATIENTS AND METHODS: Inclusion criteria in this retrospective analysis were a diagnosis of MCL between 1997 and 2007 and known date of first treatment. Hospital and research charts were reviewed for prognostic and treatment-related information. Date of death was derived from hospital records and confirmed using an online Social Security death index. RESULTS: Of 97 patients with MCL evaluated at Weill Cornell Medical Center, 31 patients (32%) were observed for more than 3 months before initial systemic therapy, with median time to treatment for the observation group of 12 months (range, 4 to 128 months). The observation group (median follow-up, 55 months) had a median age of 58 years (range, 40 to 81 years). Prognostic factors in assessable patients included advanced stage (III/IV) in 75%, elevated lactate dehydrogenase in 25%, and intermediate- or high-risk Mantle Cell International Prognostic Index in 54%. Better performance status and lower-risk standard International Prognostic Index scores were more commonly present in those undergoing observation. Although time to treatment did not predict overall survival in a multivariate analysis, the survival profile of the observation group was statistically superior to that of the early treatment group (not reached v 64 months, P = .004). CONCLUSION: In selected asymptomatic patients with MCL, deferred initial treatment ("watch and wait") is an acceptable management approach.
PURPOSE: Treatment of mantle-cell lymphoma (MCL) is nonstandardized, though patients are commonly treated immediately at diagnosis. Because data on observation, or "watch and wait," have not been previously reported, we analyzed the outcome of deferred initial therapy. PATIENTS AND METHODS: Inclusion criteria in this retrospective analysis were a diagnosis of MCL between 1997 and 2007 and known date of first treatment. Hospital and research charts were reviewed for prognostic and treatment-related information. Date of death was derived from hospital records and confirmed using an online Social Security death index. RESULTS: Of 97 patients with MCL evaluated at Weill Cornell Medical Center, 31 patients (32%) were observed for more than 3 months before initial systemic therapy, with median time to treatment for the observation group of 12 months (range, 4 to 128 months). The observation group (median follow-up, 55 months) had a median age of 58 years (range, 40 to 81 years). Prognostic factors in assessable patients included advanced stage (III/IV) in 75%, elevated lactate dehydrogenase in 25%, and intermediate- or high-risk Mantle Cell International Prognostic Index in 54%. Better performance status and lower-risk standard International Prognostic Index scores were more commonly present in those undergoing observation. Although time to treatment did not predict overall survival in a multivariate analysis, the survival profile of the observation group was statistically superior to that of the early treatment group (not reached v 64 months, P = .004). CONCLUSION: In selected asymptomatic patients with MCL, deferred initial treatment ("watch and wait") is an acceptable management approach.
Authors: Fengdong Cheng; Hongwei Wang; Pedro Horna; Zi Wang; Bijal Shah; Eva Sahakian; Karrune V Woan; Alejandro Villagra; Javier Pinilla-Ibarz; Said Sebti; Mitchell Smith; Jianguo Tao; Eduardo M Sotomayor Journal: Cancer Res Date: 2012-06-22 Impact factor: 12.701
Authors: Jia Ruan; Peter Martin; Bijal Shah; Stephen J Schuster; Sonali M Smith; Richard R Furman; Paul Christos; Amelyn Rodriguez; Jakub Svoboda; Jessica Lewis; Orel Katz; Morton Coleman; John P Leonard Journal: N Engl J Med Date: 2015-11-05 Impact factor: 91.245
Authors: Douglas E Gladstone; Javier Bolaños-Meade; Carol Ann Huff; Marianna Zahurak; Ian Flinn; Ivan Borrello; Leo Luznik; Ephraim Fuchs; Yvette Kasamon; William Matsui; Jonathan Powell; Hyam Levitsky; Robert A Brodsky; Richard Ambinder; Richard J Jones; Lode J Swinnen Journal: Leuk Lymphoma Date: 2011-07-14
Authors: Jeff D Wang; Samuel G Katz; Elizabeth A Morgan; David T Yang; Xueliang Pan; Mina L Xu Journal: Hum Pathol Date: 2019-08-16 Impact factor: 3.466
Authors: Stephen E Spurgeon; Brian G Till; Peter Martin; Andre H Goy; Martin P Dreyling; Ajay K Gopal; Michael LeBlanc; John P Leonard; Jonathan W Friedberg; Lawrence Baizer; Richard F Little; Brad S Kahl; Mitchell R Smith Journal: J Natl Cancer Inst Date: 2016-12-31 Impact factor: 13.506