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Title: Death from mantle cell lymphoma limits sequential therapy, particularly after first relapse: patterns of care and outcomes in a series from Australia and the United Kingdom.
Epworth Authors: Yannakou, Costas
Other Authors: Minson, Adrian
Hamad, Nada
Di Ciaccio, Pietro
Talaulikar, Dipti
Ku, Matthew
Ratnasingam, Sumita
Cheah, Chan
Bishton, Mark
Ng, Zi Yun
Agrawal, Shivam
McQuillan, Andrew
Johnston, Anna
Choong, Emily
Wong, Kimberley
McQuillan, James
Beekman, Ashley
Hawkes, Eliza
Dickinson, Michael
Keywords: Lymphoma
Non-Hodgkin Lymphoma
Lymphoid Malignancies
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Oct-2023
Publisher: Blackwell Scientific Publications
Citation: Br J Haematol.
Abstract: Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T-cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma-related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10-year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second-line treatment. This limitation of sequential treatment by lymphoma-related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high-risk patient populations.
DOI: 10.1111/bjh.19179
PubMed URL:
ISSN: 1365-2141
Journal Title: British Journal of Haematology
Type: Journal Article
Affiliated Organisations: Peter MacCallum Cancer Centre, Victoria, Australia
Royal Melbourne Hospital, Victoria, Australia
Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia
St Vincent's Hospital, New South Wales, Australia
Canberra Hospital, Canberra, Australian Capital Territory, Australia
St Vincent's Hospital, Victoria, Australia
Barwon Health, Victoria, Australia
Sir Charles Gairdner Hospital & Linear Health, Western Australia, Australia
Nottingham University Hospital, Nottingham, United Kingdom
Olivia Newton-John Cancer Research Institute at Austin Health, Victoria, Australia
Hollywood Private Hospital, Western Australia, Australia
Royal Hobart Hospital, Tasmania, Australia
School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Cancer Services

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