Clinical outcomes and therapeutic modalities in older Chinese patients with MCL: a multi-center real-world retrospective study.

in Annals of medicine by Yuan Yang, Ping Yang, Wei Zhang, Hui Liu, Xiuhua Sun, Xiubin Xiao, Jingwen Wang, Zhenling Li, Lihong Li, Shuye Wang, Juan He, Xiaoling Li, Qingqing Cai, Weilong Zhang, Jing Wang, Chunyuan Li, Yingtong Chen, Shuozi Liu, Hongmei Jing

TLDR

  • The study aimed to identify prognostic factors and optimal treatment modalities for older Chinese patients with MCL.
  • Results showed that ECOG score ≥ 2, high MIPI score, and absence of maintenance treatment were associated with poorer survival outcomes.

Abstract

Mantle cell lymphoma (MCL), an uncommon lymphoma subtype, is clinically characterized by its heterogenous behavior. Established prediction system including several clinical and biological parameters can help in determining the aggressiveness of MCL in younger patients. However, there are limited parameters on predicting the clinical outcome of older patients. The present study was performed to identify the prognostic factors and optimal treatment modalities in older Chinese MCL patients. Patients (age ≥ 65 yrs) with MCL from 19 comprehensive hospitals in China were included. Clinical characteristics, therapeutic strategies, progression-free survival (PFS) and overall survival (OS) time of these patients were collected. Totally, 259 eligible patients were enrolled. The median age of patients was 69 years (range, 65-88). The median of PFS and OS were 29 months (95%CI: 26-37) and 76 months (95%CI: 61-96) months, respectively. Multivariate regression analysis determined that ECOG score ≥ 2, high MIPI score and absence of maintenance treatment were independently associated with poorer PFS of MCL patients; while ECOG score ≥ 2 and absence of maintenance treatment were independently correlated with a poorer OS. Patients with MCL who received BTKi-containing regimens or maintenance therapy showed significantly longer PFS and OS than those who did not receive these therapies. Maintenance treatment can improve the survival rate of older patients with MCL regardless of TP53 status. ECOG ≥ 2, high MIPI score, and absence of maintenance therapy were associated with poorer survival outcomes for older Chinese MCL patients. Maintenance therapy and BTKi-containing regimens have been shown to increase the survival rate of older Chinese MCL patients.

Overview

  • The study aimed to identify prognostic factors and optimal treatment modalities for older Chinese patients with mantle cell lymphoma (MCL).
  • The study included patients aged 65 years and above with MCL from 19 comprehensive hospitals in China.
  • The primary objective of the study was to determine the clinical outcome of older MCL patients and identify factors associated with poorer survival outcomes.

Comparative Analysis & Findings

  • Multivariate regression analysis revealed that ECOG score ≥ 2, high MIPI score, and absence of maintenance treatment were independently associated with poorer progression-free survival (PFS) in MCL patients.
  • ECOG score ≥ 2 and absence of maintenance treatment were independently correlated with a poorer overall survival (OS) rate.
  • Patients who received BTKi-containing regimens or maintenance therapy showed significantly longer PFS and OS compared to those who did not receive these therapies.

Implications and Future Directions

  • Maintenance treatment can improve the survival rate of older patients with MCL regardless of TP53 status.
  • The study highlights the importance of considering ECOG score, MIPI score, and maintenance therapy when developing treatment strategies for older Chinese MCL patients.
  • Future studies should investigate the optimal treatment modalities for older MCL patients and examine the role of BTKi-containing regimens in this population.
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