David Bond, MD, The Ohio State University Comprehensive Cancer Center (Colombus) discusses results from a study assessed real-world clinical outcomes and predictors of survival in older patients with mantle cell lymphoma (MCL) treated in the rituximab era.
Hello. My name is David Bond. I'm an assistant professor in the lymphoma group at Ohio State University.
The abstract I'd like to discuss today is an abstract from the ASCO 2020 virtual meeting by Dr Karmali from the Northwestern University. This was abstract E20064.
This abstract was an analysis of a multi‑center cohort of patients that included 1168 patients with mantle cell lymphoma treated across 12 centers, including our own center. The focus of this abstract was analyzing 407 patients who were aged 65 and older and comparing the outcomes for these older patients to the entire cohort, and then also analyzing risk factors among all the mantle cell lymphoma patients in this retrospective cohort.
The first observation was that the progression the 2‑year progression‑free survival and overall survival were best among younger patients with a 3-year progression‑free survival of 79% among patients less than age 65, in comparison to a 2‑year progression‑free survival of 69% among patients 65 to 69 years old, and a 66% 2‑year PFS for patients aged 70 and older.
Likewise, overall survival was best among patients in the youngest cohort. The 2‑year overall survival was 92% for patients aged 64 and younger, versus 87% for patients who were aged 65 to 69, and a 2‑year overall survival of 84% among patients aged 70 and older.
Among the patients aged 65 and older, looking at risk factors for progression‑free survival and overall survival, several risk factors were identified in a multi‑variable analysis, including a higher ECOG performance score, ECOG performance score of 2 or greater, blastoid morphology, a complex carrier type, and a lack of rituximab maintenance.
Interestingly, 24% of these older patients did go on to receive autologous stem cell transplant consolidation in first remission. However, that was not associated with superior overall survival.
Overall, this abstract highlights risk factors among older patients with mantle cell lymphoma and really highlights that these older patients require a focused approach, and future clinical trials should focus on this subset of patients, which is relatively common in a disease that has a median age of around 67 years old.