Patterns in Treatment, Survival Outcomes of Older Patients With MCL
David A. Bond, MD, talks about a study that was presented at ASCO 2020 regarding practice patterns and predictors of survival in older patients with MCL in the rituximab era.
Hello. My name is David Bond. I'm an assistant professor in the lymphoma group at Ohio State University. I'm excited to be speaking today about 4 recent abstracts from the ASCO and EHA virtual meetings related to mantle cell lymphoma.
The next 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 announced as 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 are 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, both 2‑year progression‑free survival and overall survival were best among younger patients with a 3-year progression‑free survival of 79 percent among patients less than age 65, in comparison to a 2‑year progression‑free survival of 69 percent 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 two‑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.
When looking 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 a target 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.