Contemporary Treatment and Survival Outcomes in Mantle Cell Lymphoma: A National Real-World Analysis From REALYSA, a LYSA Cohort.

Fiche publication

Date publication

septembre 2026

Journal

Hematological oncology

Auteurs

Membres identifiés du Cancéropôle Est :
Pr ROSSI Cédric

Tous les auteurs :
Cheminant M, Fogarty P, Carras S, Sarkozy C, Rossi C, Fornecker L, Fontanet B, Chauchet A, Leguyader-Peyrou S, Lebras L, Oberic L, Ysebaert L, Damaj G, Labouré G, Fouillet L, Guidez S, Lemonnier F, Bouabdallah K, Gastinne T, Morineau N, Amorim S, Jardin F, Abraham J, Houot R, Thieblemont C, Morschhauser F, Gressin R, Le Gouill S, Hermine O, Cherblanc F, Monnereau A, Belot A, Ghesquieres H, Tessoulin B

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/42767676

Résumé

Although clinical trials showed outcomes improvement in MCL, their applicability to real-world practice remains limited. Using the prospective REALYSA registry (NCT03869619), we evaluated contemporary management, highlighting evolving practices and differences by age. Among 295 patients, 63% were ≥ 65 years, 48% had a high-risk MIPI score with Ki-67 ≥ 30% in 53% and aggressive morphology in 11%. Younger patients received high-dose cytarabine (93%) and ASCT (78%). Older patients were treated with bendamustine-rituximab (28%), R-CHOP (18%), and low-dose cytarabine (20%). Two-year event-free (EFS-2y) and overall (OS-2y) survivals were 80% and 89% in < 65y; 60% and 77% in ≥ 65y. Among 238 patients responders after induction, rituximab maintenance (RM) use was frequent but lower in older patients (88% vs. 76%). In time-dependent Cox models adjusted for age (< 65 vs. ≥ 65) and MIPI, RM was associated with a lower hazard of EFS events (HR 0.48; 95% CI: 0.25-0.92), although residual confounding related to treatment selection may remain. In the second-line setting (n = 72), most patients were POD24 (89%) and 56% received ibrutinib, yet outcomes remained poor (CR 24%, ORR 35%, median EFS and OS of 6.3 and 25.6 months, respectively). These findings underscore the need for improved strategies for older and high-risk patients. Retrospective landmark analyses suggest a potential association between RM and improved EFS but are limited by baseline differences between groups.