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https://doi.org/10.1186/s12885-021-08326-1
Title: | Treatment patterns and outcomes of older patients with mantle cell lymphoma in an Asian population | Authors: | Yang, Xinyi Khoo, Lay Poh Chang, Esther Wei Yin Yang, Valerie Shiwen Poon, Eileen Somasundaram, Nagavalli Farid, Mohamad Tang, Tiffany Pooi Ling Tao, Miriam Lim, Soon Thye Chan, Jason Yongsheng |
Keywords: | Chemotherapy Cytarabine Non-Hodgkin lymphoma Prognostic biomarker |
Issue Date: | 17-May-2021 | Publisher: | BioMed Central Ltd | Citation: | Yang, Xinyi, Khoo, Lay Poh, Chang, Esther Wei Yin, Yang, Valerie Shiwen, Poon, Eileen, Somasundaram, Nagavalli, Farid, Mohamad, Tang, Tiffany Pooi Ling, Tao, Miriam, Lim, Soon Thye, Chan, Jason Yongsheng (2021-05-17). Treatment patterns and outcomes of older patients with mantle cell lymphoma in an Asian population. BMC Cancer 21 (1) : 566. ScholarBank@NUS Repository. https://doi.org/10.1186/s12885-021-08326-1 | Rights: | Attribution 4.0 International | Abstract: | Background: Significant progress has been made in the treatment outcomes of mantle cell lymphoma (MCL) since the introduction of cytarabine and rituximab in modern regimens. However, older patients may not readily tolerate these agents nor derive benefit. We investigated the impact of age on treatment patterns and clinical outcomes of MCL patients in an Asian population. Methods: A retrospective study was conducted on patients (n = 66) diagnosed with MCL at the National Cancer Centre Singapore between 1998 and 2018. The median follow-up duration was 40 months. Survival analyses were performed using the Kaplan-Meier method and multivariate Cox proportional models. Results: The median age of the cohort was 59 years (range, 26–84), with a male predominance (73%). The majority (86%) had advanced stage 3–4 disease at diagnosis. Compared with younger patients, older patients aged ?60 years (n = 32; 48.5%) presented more frequently with B-symptoms (75% vs 38%, p = 0.0028), anaemia (75% vs 35%, p = 0.0013), and carried higher prognostic risk scores (sMIPI high risk 84% vs 56%, p = 0.016). Non-cytarabine-based induction chemotherapy was more commonly administered in older patients (76% vs 32%, p = 0.0012). The 5-year overall survival (OS) and progression-free survival (PFS) was 68 and 25% respectively. In a multivariable model, older age (HR 3.42, 95%CI 1.48–7.92, p = 0.004) and anemia (HR 2.56, 95%CI 1.10–5.96, p = 0.029) were independently associated with poorer OS while older age (HR 2.24, 95%CI 1.21–4.14, p = 0.010) and hypoalbuminemia (HR 2.20, 95%CI 1.17–4.13, p = 0.014) were independently associated with poorer PFS. In an exploratory analysis, maintenance rituximab following induction chemotherapy improved PFS in younger patients, with median PFS of 131 months and 45 months with or without maintenance therapy respectively (HR 0.39, 95%CI 0.16–0.93, p = 0.035). In contrast, no survival benefit was observed in older patients. Conclusions: We demonstrated in our analysis that older patients with MCL may harbor adverse clinical features and may not derive benefit from maintenance rituximab, highlighting the need for further research in this area of need. © 2021, The Author(s). | Source Title: | BMC Cancer | URI: | https://scholarbank.nus.edu.sg/handle/10635/232743 | ISSN: | 1471-2407 | DOI: | 10.1186/s12885-021-08326-1 | Rights: | Attribution 4.0 International |
Appears in Collections: | Staff Publications Elements |
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