Retrospective evaluation of demographiccharacteristics, treatment regi̇mens, and survi̇val analysis ofpatients with mantle cell lymphoma

INTRODUCTION AND AİM: Mantle Cell Lymphoma (MCL) is a B-cell neoplasm with over-expression of cyclin D1 [t(11;14)(q13;q32)]. The guidelines recommend various treatment options based on age, performance status, and comorbidities. Our purpose was to analyze the clinical features and evaluate prognostic factors for the survival of 56 MCL patients. MATERİALS AND METHODS: We retrospectively analyzed all MCL patients in Dokuz Eylül University Hospital Hematology Departments between January 2010 and June 2020. RESULTS: In this study, the average following period was 33 (1-119) months. The median age of participants was 63 years (38-84) and 75% of them were male. The first-line treatment regimens were R-CHOP in 55,4%, R-CHOP/R-DHAP+AHSCT in 23,2%, RCHOP/ R-DHAP in 14,3%, R-HyperCVAD in 1,8%, R-CVP in 1,8%, R-bortezomib in 1,8% and oncologic treatment in 1,8%. 29 patients (51,8%) had complete response, 18 patients (32,1%) had a partial response, 3 patients (5,4%) had stable disease and 6 patients (10,7%) had progression. Only 13 patients underwent autologous stem cell transplantation. In the followup, 37.9% of the cases recurred. Treatments based on lenalidomide, ibrutinib, and bortezomib were used in patients with recurrence or progression. Median overall survival (OS) was 33 months (1-119) and median disease-free survival (DFS) was 12 months (1-87). The patients who consolidated with ASCT had better PFS and OS than other patients (p=0,04). Univariate analysis showed that MIPI, MIPI-c, LDH levels, B2 microglobulin levels, and absence of B symptoms during the diagnosis affected OS in all groups (p=0,001, p=0,002, p=0,016, p=0,01 and p=0,006). Multivariate analysis showed that the age was independent prognostic risk factor (HR=0,033, 95% confidence interval 1,004-1,144, p=0,037) for OS. CONCLUSION: Median OS has been prolonged in last years with new treatment approaches but MCL is still an incurable disease. The first choice of treatment in MCL patients still unclear. Moreover, treatment regiments have been changed with new immune-modulatory agents, especially in relapsed/refractory patients. Consolidation treatment with ASCT that had better outcomes for OS and PFS should be evaluated.