Deferred treatment is a safe and viable option for selected patients with mantle cell lymphoma

• Type of Material: Article
• Authors: Oscar Calzada, Emory University; Jeffrey Switchenko, Emory University; Joseph J Maly, Ohio State University; Kristie Blum, Emory University; Natalie Grover, University of North Carolina; Stephanie Mathews, University of North Carolina; Steven I Park, University of North Carolina; Max Gordon, Oregon Health and Science University; Christopher Flowers, Emory University; Jonathon Cohen, Emory University
• Language: English
• Date: 2018-12-02
• Publisher: Taylor & Francis LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
• Final Published Version (URL): http://dx.doi.org/10.1080/10428194.2018.1455973
• Title of Journal or Parent Work: Leukemia & Lymphoma
• Volume: 59
• Issue: 12
• Start Page: 2862
• End Page: 2870
• Grant/Funding Information: This work received grant funding from the Lymphoma Research Foundation and the American Society of Hematology.; Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.
• Keywords: Oncology; Life Sciences & Biomedicine; KI-67; non-Hodgkin's lymphoma; TP53; MIPI; EXPRESSION; Mantle cell lymphoma; TRIALS; deferred therapy; Science & Technology; SURVIVAL; THERAPY; PROGNOSTIC INDEX; Hematology
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Oncology

Abstract

Prospective identification of candidates for deferred therapy is not standardized and many patients receive immediate therapy regardless of risk. We conducted a retrospective, multi-center cohort analysis of MCL patients with comprehensive clinical data to examine the use and safety of deferred therapy for newly diagnosed patients. Previously untreated patients ≥18 years-old with MCL diagnosed in 1993–2015 at five academic sites were included. Of 395 patients, 72 (18%) received deferred therapy (defined as receipt of first treatment >90 days following initial diagnosis). Patients receiving deferred therapy were more likely to have an ECOG performance status of 0 (67 versus 44% p =.001), have no B symptoms (83 versus 65% p =.003) and have normal LDH levels at diagnosis (87 versus 55% p <.001). In multivariable analysis, deferred therapy was not associated with a significant difference in OS (HR 0.64: 95% CI 0.22–1.84, p =.407).