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Alternating R‐CHOP and R ‐cytarabine is a safe and effective regimen for transplant‐ineligible patients with a newly diagnosed mantle cell lymphoma
Author(s) -
Klener Pavel,
Fronkova Eva,
Belada David,
Forsterova Kristina,
Pytlik Robert,
Kalinova Marketa,
Simkovic Martin,
Salek David,
Mocikova Heidi,
Prochazka Vit,
Blahovcova Petra,
Janikova Andrea,
Markova Jana,
Obr Ales,
Berkova Adela,
Kubinyi Jozef,
Vaskova Martina,
Mejstrikova Ester,
Campr Vit,
Jaksa Radek,
Kodet Roman,
Michalova Kyra,
Trka Jan,
Trneny Marek
Publication year - 2018
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2483
Subject(s) - medicine , cytarabine , mantle cell lymphoma , regimen , gastroenterology , surgery , international prognostic index , rituximab , oncology , lymphoma , chemotherapy
Implementation of cytarabine into induction therapy became standard of care for younger patients with mantle cell lymphoma (MCL). On the basis of its beneficial impact, many centers incorporated cytarabine at lower doses also into first‐line treatments of elderly patients. We conducted a multicenter observational study that prospectively analyzed safety and efficacy of alternating 3 + 3 cycles of R‐CHOP and R‐cytarabine for newly diagnosed transplant‐ineligible MCL patients. A total of 73 patients were enrolled with median age 70 years. Most patients had intermediate (39.7%) and high‐risk (50.7%) disease according to MCL international prognostic index. Rituximab maintenance was initiated in 58 patients. Overall response rate reached 89% by positron emission tomography–computed tomography, including 75.3% complete remissions. Two patients (2.7%) did not complete the induction therapy because of toxicity. Three patients (4.1%) were considered nonresponders, which led to therapy change before completion of induction. Estimated progression‐free survival and overall survival were 51.3% and 68.6% at 4 years, respectively. Mantle cell lymphoma international prognostic index, bulky disease (≥ 5 cm), and achievement of positron emission tomography–negativity independently correlated with progression‐free survival. Grade 3 to 4 hematologic and nonhematologic toxicity was documented in 48% and 20.5% patients, respectively. Alternation of R‐CHOP and R‐cytarabine represents feasible and very effective regimen for elderly/comorbid MCL patients. This study was registered at GovTrial ( clinicaltrials.gov ) NCT03054883.