Death from mantle cell lymphoma limits sequential therapy, particularly after first relapse: Patterns of care and outcomes in a series from Australia and the United Kingdom

Minson, A; Hamad, N; Di Ciaccio, P; Talaulikar, D; Ku, M; Ratnasingam, S; Cheah, C; Yannakou, CK; Bishton, M; Ng, ZY; Agrawal, S; McQuillan, A; Johnston, A; Choong, E; Wong, K; McQuillan, J; Beekman, A; Hawkes, E; Dickinson, M

Author(s): Minson, A; Hamad, N; Di Ciaccio, P; Talaulikar, D; Ku, M; Ratnasingam, S; Cheah, C; Yannakou, CK; Bishton, M; Ng, ZY; Agrawal, S; McQuillan, A; Johnston, A; Choong, E; Wong, K; McQuillan, J; Beekman, A; Hawkes, E; Dickinson, M;
Details: Publication Year 2024-02,Volume 204,Issue #2,Page 548-554
Journal Title: British Journal of Haematology
Publication Type: Research article
Abstract: Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T-cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma-related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10-year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second-line treatment. This limitation of sequential treatment by lymphoma-related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high-risk patient populations.
Publisher: Wiley
Keywords: Adult; Humans; Australia; *Lymphoma, Mantle-Cell/drug therapy; Neoplasm Recurrence, Local; Retrospective Studies; United Kingdom; lymphoid malignancies; lymphomas; new drugs for lymphoma
Department(s): Clinical Haematology
Publisher's Version: https://doi.org/10.1111/bjh.19179
Open Access at Publisher's Site: https://doi.org/10.1111/bjh.19179
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-03-13 05:27:10

Last Modified: 2024-03-13 05:27:28