B S Dabaja1, A D Zelenetz2, A K Ng3, R W Tsang4, S Qi2, P K Allen1, D Hodgson4, U Ricardi5, R T Hoppe6, R Advani6, P M Mauch3, L S Constine7, L Specht8, Y Li9, S A Terezakis10, A Wirth11, G Reinartz12, H T Eich12, B M P Aleman13, P Barr7, J Yahalom2. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston. 2. Memorial Sloan-Kettering Cancer Center, New York. 3. Department of Radiation Oncology, Brigham & Women's Hospital, Boston, USA. 4. Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Canada. 5. Department of Oncology, University of Turin, Turin, Italy. 6. Stanford University, Stanford. 7. University of Rochester Medical Center, Rochester, USA. 8. Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 9. Department of Radiation Oncology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 10. Department of Radiation Oncology, Johns Hopkins School of Medicine, Baltimore, USA. 11. Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia. 12. Department of Radiation Oncology, University of Muenster, Muenster, Germany. 13. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Mantle cell lymphoma (MCL) rarely presents as early-stage disease, but clinical observations suggest that patients who present with early-stage disease may have better outcomes than those with advanced-stage disease. PATIENTS AND METHODS: In this 13-institution study, we examined outcomes among 179 patients with early-stage (stage I or II) MCL in an attempt to identify prognostic factors that influence treatment selection and outcome. Variables examined included clinical characteristics, treatment modality, response to therapy, sites of failure, and survival. RESULTS: Patients were predominantly male (78%) with head and neck being the most common presenting sites (75%). Most failures occurred outside the original disease site (79%). Although the administration of radiation therapy, either alone or with chemotherapy, reduced the risk of local failure, it did not translate into an improved freedom from progression or overall survival (OS). The treatment outcomes were independent of treatment modality. The 10-year OS for patients treated with chemotherapy alone, chemo-radiation therapy and radiation therapy alone were 69%, 62%, and 74% (P = 0.79), and the 10-year freedom from progression were 46%, 43%, and 31% (P = 0.64), respectively. CONCLUSION: Given the excellent OS rates regardless of initial therapy in patients with early-stage MCL, de-intensified therapy to limit treatment-related toxicity is a reasonable approach.
BACKGROUND: Mantle cell lymphoma (MCL) rarely presents as early-stage disease, but clinical observations suggest that patients who present with early-stage disease may have better outcomes than those with advanced-stage disease. PATIENTS AND METHODS: In this 13-institution study, we examined outcomes among 179 patients with early-stage (stage I or II) MCL in an attempt to identify prognostic factors that influence treatment selection and outcome. Variables examined included clinical characteristics, treatment modality, response to therapy, sites of failure, and survival. RESULTS: Patients were predominantly male (78%) with head and neck being the most common presenting sites (75%). Most failures occurred outside the original disease site (79%). Although the administration of radiation therapy, either alone or with chemotherapy, reduced the risk of local failure, it did not translate into an improved freedom from progression or overall survival (OS). The treatment outcomes were independent of treatment modality. The 10-year OS for patients treated with chemotherapy alone, chemo-radiation therapy and radiation therapy alone were 69%, 62%, and 74% (P = 0.79), and the 10-year freedom from progression were 46%, 43%, and 31% (P = 0.64), respectively. CONCLUSION: Given the excellent OS rates regardless of initial therapy in patients with early-stage MCL, de-intensified therapy to limit treatment-related toxicity is a reasonable approach.
Authors: Matthew S Ning; Chelsea C Pinnix; Bhavana V Chapman; Jillian R Gunther; Sarah A Milgrom; Joseph D Khoury; Preetesh Jain; Wendy Y Chen; Onyeka N Oriabure; Maria R Badillo; L Michael Wang; Bouthaina S Dabaja Journal: Blood Adv Date: 2019-07-09