Academic Journal
أعرض في EDS

Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherapy: A UK and Ireland analysis

التفاصيل البيبلوغرافية
العنوان: Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherapy: A UK and Ireland analysis
المؤلفون: Rampotas, A, Wilson, MR, Lomas, O, Denny, N, Leary, H, Ferguson, G, McKay, P, Ebsworth, T, Miller, J, Shah, N, Martinez-Calle, N, Bishton, M, Everden, A, Tucker, D, El-Hassad, E, Hennessy, B, Doherty, D, Prideaux, S, Faryal, R, Hayat, A, Keohane, C, Marr, H, Gibb, A, Pocock, R, Lambert, J, Lacey, R, Elmusharaf, N, Clifford, R, Eyre, TA
المصدر: British Journal of Haematology , 194 (2) pp. 365-377. (2021)
بيانات النشر: WILEY
سنة النشر: 2021
المجموعة: University College London: UCL Discovery
مصطلحات موضوعية: Mantle cell lymphoma, immunochemotherapy, elderly, frail, unfit
الوصف: Mantle cell lymphoma (MCL) presenting in elderly, unfit patients represents a clinical challenge. Front-line ‘attenuated’ or low-intensity immunochemotherapy is often employed, although outcomes are relatively unexplored. We report outcomes of attenuated immunochemotherapy in 95 patients with MCL across 19 centres in the UK and Ireland considered unfit for full-dose rituximab-bendamustine or rituximab-cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP). Regimens examined were rituximab-cyclophosphamide, vincristine, prednisolone (R-CVP) (n = 19), dose-attenuated R-CHOP (n = 22), dose attenuated rituximab-bendamustine (n = 24) and rituximab-chlorambucil (n = 30). The primary outcome was progression-free survival (PFS). The secondary outcomes included overall response, overall survival (OS) and toxicity. The median (range) age was 79 (58–89) years and 50% were aged ≥80 years. The median (range) Cumulative Illness Rating Scale-Geriatric score was 6 (0–24). The median PFS for all patients was 15 months [95% confidence interval (CI) 8·7–21·2) and median OS was 31·4 months (95% CI 19·7–43·2). By multivariable analysis (MVA), the only clinical factor associated with an inferior PFS was blastoid morphology [hazard ratio (HR) 2·90, P = 0·01). Notably, higher treatment intensity (R-CHOP/R-bendamustine composite) provided an independently superior PFS compared with R-CVP/R-chlorambucil (MVA HR 0·49, P = 0·02). Factors associated with inferior OS by MVA were Eastern Cooperative Oncology Group Performance Status (HR 2·14, P = 0·04), blastoid morphology (HR 4·08, P = 0·001) and progression of disease at <24 months status (HR 5·68, P < 0·001). Overall, survival after front-line dose-attenuated immunochemotherapy is unsatisfactory. Clinical trials investigating novel agents such as Bruton tyrosine kinase and B-cell lymphoma 2 inhibitors in this specific clinical setting are warranted.
نوع الوثيقة: article in journal/newspaper
وصف الملف: text
اللغة: English
Relation: https://discovery.ucl.ac.uk/id/eprint/10135721/1/Rampotas_Treatment%20patterns%20and%20outcomes%20of%20unfit%20and%20elderly%20patients%20with%20Mantle%20cell%20lymphoma%20unfit%20for%20standard%20immunochemotherap_AAM.pdf; https://discovery.ucl.ac.uk/id/eprint/10135721/
الاتاحة: https://discovery.ucl.ac.uk/id/eprint/10135721/1/Rampotas_Treatment%20patterns%20and%20outcomes%20of%20unfit%20and%20elderly%20patients%20with%20Mantle%20cell%20lymphoma%20unfit%20for%20standard%20immunochemotherap_AAM.pdf
https://discovery.ucl.ac.uk/id/eprint/10135721/
Rights: open
رقم الانضمام: edsbas.A581AA7D
قاعدة البيانات: BASE
ResultId 1
Header edsbas
BASE
edsbas.A581AA7D
919
3
Academic Journal
academicJournal
918.9462890625
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=edsbas&AN=edsbas.A581AA7D&custid=s6537998&authtype=sso
FullText Array ( [Availability] => 0 )
Array ( [0] => Array ( [Url] => https://discovery.ucl.ac.uk/id/eprint/10135721/1/Rampotas_Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherap_AAM.pdf# [Name] => EDS - BASE [Category] => fullText [Text] => View record in BASE [MouseOverText] => View record in BASE ) )
Items Array ( [Name] => Title [Label] => Title [Group] => Ti [Data] => Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherapy: A UK and Ireland analysis )
Array ( [Name] => Author [Label] => Authors [Group] => Au [Data] => &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rampotas%2C+A%22&quot;&gt;Rampotas, A&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wilson%2C+MR%22&quot;&gt;Wilson, MR&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lomas%2C+O%22&quot;&gt;Lomas, O&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Denny%2C+N%22&quot;&gt;Denny, N&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Leary%2C+H%22&quot;&gt;Leary, H&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ferguson%2C+G%22&quot;&gt;Ferguson, G&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22McKay%2C+P%22&quot;&gt;McKay, P&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ebsworth%2C+T%22&quot;&gt;Ebsworth, T&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Miller%2C+J%22&quot;&gt;Miller, J&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Shah%2C+N%22&quot;&gt;Shah, N&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Martinez-Calle%2C+N%22&quot;&gt;Martinez-Calle, N&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bishton%2C+M%22&quot;&gt;Bishton, M&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Everden%2C+A%22&quot;&gt;Everden, A&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tucker%2C+D%22&quot;&gt;Tucker, D&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22El-Hassad%2C+E%22&quot;&gt;El-Hassad, E&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hennessy%2C+B%22&quot;&gt;Hennessy, B&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Doherty%2C+D%22&quot;&gt;Doherty, D&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Prideaux%2C+S%22&quot;&gt;Prideaux, S&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Faryal%2C+R%22&quot;&gt;Faryal, R&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hayat%2C+A%22&quot;&gt;Hayat, A&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Keohane%2C+C%22&quot;&gt;Keohane, C&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Marr%2C+H%22&quot;&gt;Marr, H&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gibb%2C+A%22&quot;&gt;Gibb, A&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pocock%2C+R%22&quot;&gt;Pocock, R&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lambert%2C+J%22&quot;&gt;Lambert, J&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lacey%2C+R%22&quot;&gt;Lacey, R&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Elmusharaf%2C+N%22&quot;&gt;Elmusharaf, N&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clifford%2C+R%22&quot;&gt;Clifford, R&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Eyre%2C+TA%22&quot;&gt;Eyre, TA&lt;/searchLink&gt; )
Array ( [Name] => TitleSource [Label] => Source [Group] => Src [Data] => British Journal of Haematology , 194 (2) pp. 365-377. (2021) )
Array ( [Name] => Publisher [Label] => Publisher Information [Group] => PubInfo [Data] => WILEY )
Array ( [Name] => DatePubCY [Label] => Publication Year [Group] => Date [Data] => 2021 )
Array ( [Name] => Subset [Label] => Collection [Group] => HoldingsInfo [Data] => University College London: UCL Discovery )
Array ( [Name] => Subject [Label] => Subject Terms [Group] => Su [Data] => &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Mantle+cell+lymphoma%22&quot;&gt;Mantle cell lymphoma&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22immunochemotherapy%22&quot;&gt;immunochemotherapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22elderly%22&quot;&gt;elderly&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22frail%22&quot;&gt;frail&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22unfit%22&quot;&gt;unfit&lt;/searchLink&gt; )
Array ( [Name] => Abstract [Label] => Description [Group] => Ab [Data] => Mantle cell lymphoma (MCL) presenting in elderly, unfit patients represents a clinical challenge. Front-line ‘attenuated’ or low-intensity immunochemotherapy is often employed, although outcomes are relatively unexplored. We report outcomes of attenuated immunochemotherapy in 95 patients with MCL across 19 centres in the UK and Ireland considered unfit for full-dose rituximab-bendamustine or rituximab-cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP). Regimens examined were rituximab-cyclophosphamide, vincristine, prednisolone (R-CVP) (n = 19), dose-attenuated R-CHOP (n = 22), dose attenuated rituximab-bendamustine (n = 24) and rituximab-chlorambucil (n = 30). The primary outcome was progression-free survival (PFS). The secondary outcomes included overall response, overall survival (OS) and toxicity. The median (range) age was 79 (58–89) years and 50% were aged ≥80 years. The median (range) Cumulative Illness Rating Scale-Geriatric score was 6 (0–24). The median PFS for all patients was 15 months [95% confidence interval (CI) 8&#183;7–21&#183;2) and median OS was 31&#183;4 months (95% CI 19&#183;7–43&#183;2). By multivariable analysis (MVA), the only clinical factor associated with an inferior PFS was blastoid morphology [hazard ratio (HR) 2&#183;90, P = 0&#183;01). Notably, higher treatment intensity (R-CHOP/R-bendamustine composite) provided an independently superior PFS compared with R-CVP/R-chlorambucil (MVA HR 0&#183;49, P = 0&#183;02). Factors associated with inferior OS by MVA were Eastern Cooperative Oncology Group Performance Status (HR 2&#183;14, P = 0&#183;04), blastoid morphology (HR 4&#183;08, P = 0&#183;001) and progression of disease at &lt;24 months status (HR 5&#183;68, P &lt; 0&#183;001). Overall, survival after front-line dose-attenuated immunochemotherapy is unsatisfactory. Clinical trials investigating novel agents such as Bruton tyrosine kinase and B-cell lymphoma 2 inhibitors in this specific clinical setting are warranted. )
Array ( [Name] => TypeDocument [Label] => Document Type [Group] => TypDoc [Data] => article in journal/newspaper )
Array ( [Name] => Format [Label] => File Description [Group] => SrcInfo [Data] => text )
Array ( [Name] => Language [Label] => Language [Group] => Lang [Data] => English )
Array ( [Name] => NoteTitleSource [Label] => Relation [Group] => SrcInfo [Data] => https://discovery.ucl.ac.uk/id/eprint/10135721/1/Rampotas_Treatment%20patterns%20and%20outcomes%20of%20unfit%20and%20elderly%20patients%20with%20Mantle%20cell%20lymphoma%20unfit%20for%20standard%20immunochemotherap_AAM.pdf; https://discovery.ucl.ac.uk/id/eprint/10135721/ )
Array ( [Name] => URL [Label] => Availability [Group] => URL [Data] => https://discovery.ucl.ac.uk/id/eprint/10135721/1/Rampotas_Treatment%20patterns%20and%20outcomes%20of%20unfit%20and%20elderly%20patients%20with%20Mantle%20cell%20lymphoma%20unfit%20for%20standard%20immunochemotherap_AAM.pdf&lt;br /&gt;https://discovery.ucl.ac.uk/id/eprint/10135721/ )
Array ( [Name] => Copyright [Label] => Rights [Group] => Cpyrght [Data] => open )
Array ( [Name] => AN [Label] => Accession Number [Group] => ID [Data] => edsbas.A581AA7D )
RecordInfo Array ( [BibEntity] => Array ( [Languages] => Array ( [0] => Array ( [Text] => English ) ) [Subjects] => Array ( [0] => Array ( [SubjectFull] => Mantle cell lymphoma [Type] => general ) [1] => Array ( [SubjectFull] => immunochemotherapy [Type] => general ) [2] => Array ( [SubjectFull] => elderly [Type] => general ) [3] => Array ( [SubjectFull] => frail [Type] => general ) [4] => Array ( [SubjectFull] => unfit [Type] => general ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherapy: A UK and Ireland analysis [Type] => main ) ) ) [BibRelationships] => Array ( [HasContributorRelationships] => Array ( [0] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Rampotas, A ) ) ) [1] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Wilson, MR ) ) ) [2] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Lomas, O ) ) ) [3] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Denny, N ) ) ) [4] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Leary, H ) ) ) [5] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Ferguson, G ) ) ) [6] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => McKay, P ) ) ) [7] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Ebsworth, T ) ) ) [8] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Miller, J ) ) ) [9] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Shah, N ) ) ) [10] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Martinez-Calle, N ) ) ) [11] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Bishton, M ) ) ) [12] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Everden, A ) ) ) [13] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Tucker, D ) ) ) [14] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => El-Hassad, E ) ) ) [15] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Hennessy, B ) ) ) [16] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Doherty, D ) ) ) [17] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Prideaux, S ) ) ) [18] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Faryal, R ) ) ) [19] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Hayat, A ) ) ) [20] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Keohane, C ) ) ) [21] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Marr, H ) ) ) [22] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Gibb, A ) ) ) [23] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Pocock, R ) ) ) [24] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Lambert, J ) ) ) [25] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Lacey, R ) ) ) [26] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Elmusharaf, N ) ) ) [27] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Clifford, R ) ) ) [28] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Eyre, TA ) ) ) ) [IsPartOfRelationships] => Array ( [0] => Array ( [BibEntity] => Array ( [Dates] => Array ( [0] => Array ( [D] => 01 [M] => 01 [Type] => published [Y] => 2021 ) ) [Identifiers] => Array ( [0] => Array ( [Type] => issn-locals [Value] => edsbas ) [1] => Array ( [Type] => issn-locals [Value] => edsbas.oa ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => British Journal of Haematology , 194 (2) pp. 365-377. (2021 [Type] => main ) ) ) ) ) ) )
IllustrationInfo