@article{cb58438299a54e1aa8e0220a2e4d3996,
title = "Intensive induction regimens after deferring initial therapy for mantle cell lymphoma are not associated with improved survival",
abstract = "Introduction: While most patients with mantle cell lymphoma (MCL) receive therapy shortly after diagnosis, a subset of patients with indolent-behaving disease can safely defer treatment. In this subgroup, we evaluated the importance of treatment intensity in patients with MCL who defer initial therapy. Methods: Out of 1134 patients with MCL from 12 academic centers, we analyzed 219 patients who initiated therapy at least 90 days after diagnosis. Patients who received induction with high-dose cytarabine and/or autologous stem cell transplantation (ASCT) in first remission were considered to have received intensive therapy (n = 88) while all other approaches were non-intensive (n = 131). Results: There was no difference in progression-free (PFS; P =.224) or overall survival (OS; P =.167) in deferred patients who received non-intensive vs. intensive therapy. Additionally, univariate and multivariate Cox proportional hazards models were performed for PFS and OS. Treatment at an academic center (HR 0.43, P =.015) was associated with improved OS in both univariate and multivariate models, while intensity of treatment was not associated with improved OS in either model. Conclusions: These results indicate that intensified initial treatment is not associated with improved survival after deferring initial therapy, although prospective studies are needed to determine which of these patients with MCL may benefit from intensive therapy.",
keywords = "deferred, intensive therapy, mantle cell lymphoma, time to treatment",
author = "Krithika Shanmugasundaram and Subir Goyal and Jeffery Switchenko and Oscar Calzada and Churnetski, {Michael C.} and Bhaskar Kolla and Veronika Bachanova and Gerson, {James N.} and Barta, {Stefan K.} and Gordon, {Max J.} and Danilov, {Alexey V.} and Grover, {Natalie S.} and Stephanie Mathews and Madelyn Burkart and Reem Karmali and Yazeed Sawalha and Hill, {Brian T.} and Nilanjan Ghosh and Park, {Steven I.} and Narendranath Epperla and Bond, {David A.} and Talha Badar and Blum, {Kristie A.} and Mehdi Hamadani and Fenske, {Timothy S.} and Mary Malecek and Kahl, {Brad S.} and Peter Martin and Jin Guo and Flowers, {Christopher R.} and Cohen, {Jonathon B.}",
note = "Funding Information: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and the National Cancer Institute under award number P30CA138292. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: 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. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2021",
month = sep,
doi = "10.1111/ejh.13649",
language = "English",
volume = "107",
pages = "301--310",
journal = "European Journal of Haematology",
issn = "0902-4441",
number = "3",
}