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1702 Overall Survival (OS) Benefit of Rituximab Based Immunochemotherapy Followed by Post-Induction Treatment in Mantle Cell Lymphoma (MCL): a Retrospective Analysis of 279 Patients Treated by Polish Lymphoma Research Group (PLRG) Centers

Oral and Poster Abstracts
Poster Session: Lymphoma: Therapy with Biologic Agents, excluding Pre-Clinical Models Poster I
Saturday, December 5, 2009, 5:30 PM-7:30 PM
Hall E (Ernest N. Morial Convention Center)
Poster Board I-724

Wojciech Jurczak1, Michal Szymczyk2*, Agnieszka Giza3*, Monika Joks4*, Elzbieta Kisiel5*, Beata Stella-Holowiecka6*, Piotr Boguradzki7*, Tomasz Wrobel8, Magdalena Sikorska9*, Wanda Knopinska-Posluszny10*, Ewa Kalinka-Warzocha11*, Jan Walewski12 and Aleksander B. Skotnicki13*

1Department of Hematology, CMUJ, Krakow, Poland
2Lymphoma Department, COI, Warsaw, Poland
3Dpt of Hematology, CMUJ, Krakow, Poland
4Dpt of Hematology, AM, Poznan, Poland
5Institute of Hematology, Warsaw, Poland
6Dpt of Hematology, SLAM, Katowice, Poland
7Dpt of Hematol, AM, Warsaw, Poland
8Hematology, Wroclaw Medical University, Wroclaw, Poland
9COI, Olsztyn, Poland
10AM, Gdansk, Poland
11AM, Lodz, Poland
12Lymphoma Dpt, COI, Warsaw, Poland
13Collegium Medicum, Uniwersytetu Jagielonskiego, Krakow, Poland

Background:  ASCT consolidation in the first remission is the treatment of choice in MCL patients. However lack of adequate response to the first line therapy, elderly age and co-existing co-morbidities makes it feasible for less than a third of patients.

Methods:  Retrospective analysis of 279 MCL cases treated at 10 PLRG centers was performed:  52% of them (144 pts) received Rituximab in induction therapy;  35% (97 pts) were subjected to post-induction therapy (ASTC – 16%, radioimmunotherapy consolidation – 13% and Rituximab maintenance – 6%). There were no significant differences in risk factor distribution among analyzed subgroups.

Results:

1)      At 5 years OS was 40% in the whole group: 77% for those subjected to post-induction therapy vs 25% for those who were not; 5 year PFS is 20%, 48% and 5% respectively (p<0,0001, in both comparisons).

2)      Pts with initial good response, whose treatment was NOT continued after induction, had inferior results (5 year OS and PFS – 30 and 10 % respectively) to those subjected to post-induction therapy (p<0,0001).

3)      Rituximab included in the first line regimens increased RR, increasing % of pts that could be subjected to post-induction therapy:  progression/ death during the first line therapy were 5,5% (8/144 Rituximab treated pts)  as compared to 15,5% (21/135 treated without Rituximab).

Conclusions:  With  all  limitations  of  retrospective  analysis,  it  strongly  supports   the  necessity  of  Rituximab immunochemotherapy followed by post  induction  treatment  in  MCL  pts.  The  role  of  ASCT  is  established  in  younger  patients,  radioimmunotherapy  consolidation or Rituximab maintenance should be considered in elderly  and  unfit  ones.   

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH