Division of Hematology, The Ohio State University, Columbus, OH.
Winship Cancer Institute, Biostatistics and Bioinformatics, Emory University, Atlanta, GA.
Blood Adv. 2021 Dec 14;5(23):5179-5189. doi: 10.1182/bloodadvances.2021004765.
Although an expanding array of effective treatments has resulted in recent improvement in survival of patients with mantle cell lymphoma (MCL), outcomes remain heterogeneous, and identification of prognostic factors remains a priority. We assessed the prognostic impact of time to progression of disease (POD) after first-line therapy among 455 patients with relapsed MCL. Patients were categorized by duration of first remission as PRF/POD6, defined as progressive disease during induction or POD within 6 months of diagnosis (n = 65; 14%); POD6-24, defined as POD between 6 and 24 months after diagnosis (n = 153; 34%); and POD>24, defined as POD >24 months after diagnosis (n = 237; 53%). The median overall survival from POD (OS2) was 1.3 years (95% confidence interval [CI], 0.9-2.4) for patients with PRF/POD6, 3 years (95% CI, 2-6.8) for those with POD6-24, and 8 years (95% CI, 6.2-NR) for those with POD>24. Median OS2 was inferior in patients with early POD (defined as PRF/POD6 or POD6-24) after both intensive and less intensive frontline treatment. The prognostic performance of time until POD was replicated in an independent cohort of 245 patients with relapsed MCL, with median OS2 of 0.3 years (95% CI, 0.1-0.5) for PRF/POD6, 0.8 years (95% CI, 0.6-0.9) for POD6-24, and 2.4 years (95% CI 2.1-2.7) for POD>24. Early POD is associated with inferior OS2 in patients with relapsed MCL, identifying a high-risk population for future prospective studies.
尽管越来越多的有效治疗方法使得套细胞淋巴瘤（MCL）患者的生存状况得到了近期改善，但结果仍然存在异质性，确定预后因素仍然是当务之急。我们评估了 455 例复发 MCL 患者一线治疗后疾病进展时间（POD）对预后的影响。根据首次缓解的持续时间，将患者分为 PRF/POD6、POD6-24 和 POD>24 组。PRF/POD6 组定义为诱导期或诊断后 6 个月内疾病进展（n=65；14%）；POD6-24 组定义为诊断后 6-24 个月内 POD（n=153；34%）；POD>24 组定义为诊断后 POD>24 个月（n=237；53%）。从 POD（OS2）开始，PRF/POD6 患者的中位总生存时间为 1.3 年（95%CI，0.9-2.4），POD6-24 患者为 3 年（95%CI，2-6.8），POD>24 患者为 8 年（95%CI，6.2-NR）。在接受强化和非强化一线治疗的患者中，早期 POD（定义为 PRF/POD6 或 POD6-24）患者的 OS2 较差。在另一项 245 例复发 MCL 患者的独立队列中，POD 时间的预后性能得到了复制，PRF/POD6 患者的中位 OS2 为 0.3 年（95%CI，0.1-0.5），POD6-24 患者为 0.8 年（95%CI，0.6-0.9），POD>24 患者为 2.4 年（95%CI 2.1-2.7）。复发 MCL 患者早期 POD 与 OS2 不良相关，这为未来前瞻性研究确定了高危人群。
