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Harmanen M, Sorigue M, Khan M, Prusila R, Klaavuniemi T, Kari E, Jantunen E, Sunela K, Rajamäki A, Alanne E, Kuitunen H, Jukkola A, Sancho JM, Kuittinen O, Rönkä A. Front-line and second-line treatment for mantle cell lymphoma in clinical practice: A multicenter retrospective analysis. Eur J Haematol 2024. [PMID: 38661269 DOI: 10.1111/ejh.14219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND There are few reports of clinical practice treatment patterns and efficacy in mantle cell lymphoma (MCL). MATERIALS AND METHODS We retrospectively studied a large, multicenter, cohort of patients with MCL diagnosed between 2000 and 2020 in eight institutions. RESULTS 536 patients were registered (73% male, median of 70 years). Front-line treatment was based on high-dose cytarabine, bendamustine, and anthracyclines in 42%, 12%, and 15%, respectively. The median PFS for all patients was 45 months; 68, 34, and 30 months for those who received high-dose cytarabine-based, bendamustine-based and anthracycline-based therapy. 204 patients received second-line. Bendamustine-based treatment was the most common second-line regimen (36% of patients). The median second-line PFS (sPFS) for the entire cohort was 14 months; 19, 24, and 31 for bendamustine-, platinum-, and high-dose cytarabine-based regimens, with broad confidence intervals for these latter estimates. Patients treated with cytarabine-based therapies in the front-line and those with front-line PFS longer than 24 months had a substantially superior sPFS. CONCLUSION Front-line treatment in this cohort of MCL was as expected and with a median PFS of over 3.5 years. Second-line treatment strategies were heterogeneous and the median second-line PFS was little over 1 year.
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Affiliation(s)
- Minna Harmanen
- University of Eastern Finland, Faculty of Health Sciences Medicine, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
| | - Marc Sorigue
- Medical Department, Trialing Health, Barcelona, Spain
| | - Madiha Khan
- University of Eastern Finland, Faculty of Health Sciences Medicine, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
| | - Roosa Prusila
- Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Esa Kari
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Esa Jantunen
- Department of Medicine, University of Eastern Finland, Institute of Clinical Medicine/Internal Medicine, Hospital District of North Carelia, Kuopio University Hospital, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Kaisa Sunela
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Aino Rajamäki
- University of Eastern Finland, Faculty of Health Sciences Medicine, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
- Department of Oncology, Hospital Nova of Central Finland, Jyväskylä, Finland
| | - Erika Alanne
- Department of Oncology and Radiotherapy, Turku University Hospital, Western Finland Cancer Centre, Turku, Finland
| | - Hanne Kuitunen
- Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Arja Jukkola
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juan-Manuel Sancho
- University of Eastern Finland, Faculty of Health Sciences Medicine, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
- Department of Hematology, ICO-Badalona, IJC, UAB, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Outi Kuittinen
- Department of Oncology, Kuopio University Hospital, Kuopio, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Aino Rönkä
- Department of Oncology, Kuopio University Hospital, Kuopio, Finland
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Kaprio E, Prusila R, Tokola S, Kuusisto MEL, Jantunen E, Kuitunen H, Turpeenniemi‐Hujanen T, Kuittinen O. Drug-induced pneumonitis risk in diffuse large B-cell/follicular lymphoma patients treated with R-CHOP-like regimen is associated with the use of granulocyte colony-stimulating growth factors. Cancer Med 2024; 13:e6898. [PMID: 38164067 PMCID: PMC10807566 DOI: 10.1002/cam4.6898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Rituximab-based combinations are the standard of care in diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Despite being on market for over 20 years, some of the adverse effects associated with the use of rituximab are not well known. Drug-induced interstitial pneumonitis (DIP) is a potentially fatal complication of the treatment. Granulocyte colony-stimulating factors (G-CSF) are supportive agents commonly used to prevent neutropenic infections. G-CSF are reported to have pulmonary toxicity, but the risk of DIP is greater when used in combination with other potentially pulmotoxic agents. METHODS In this retrospective study, we reported the G-CSF use and risk of DIP in 234 DLBCL patients and 87 FL patients receiving R-CHOP-type immunochemotherapy. RESULTS In 72% of patients, the treatment included a G-CSF support. The overall incidence of treatment-induced pneumonitis was 6.9% in this patient group. All the DIP cases (n = 16) were among patients receiving G-CSF support (p = 0.03). Older age (over 60 years) and higher disease stage (Ann Arbor 3-4) also increased the risk of DIP. CONCLUSIONS These findings suggest that the use of G-CSF increases the risk of DIP, when used in combination with rituximab-containing regimen.
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Affiliation(s)
- Elina Kaprio
- Faculty of Health Medicine, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
| | - Roosa Prusila
- Department of PediatricsKuopio University HospitalKuopioFinland
| | - Susanna Tokola
- Department of Oncology and Radiotherapy, Medical Research CenterOulu University HospitalOuluFinland
| | - Milla E. L. Kuusisto
- Translational Medicine Research UnitUniversity of OuluOuluFinland
- The North Karelia Central HospitalJoensuuFinland
- Cancer Center, Kuopio University HospitalKuopioFinland
| | - Esa Jantunen
- The North Karelia Central HospitalJoensuuFinland
- Länsi‐Pohja Central Hospital, Kauppakatu 25KemiFinland
| | - Hanne Kuitunen
- Department of Oncology and Radiotherapy, Medical Research CenterOulu University HospitalOuluFinland
- Translational Medicine Research UnitUniversity of OuluOuluFinland
| | - Taina Turpeenniemi‐Hujanen
- Department of Oncology and Radiotherapy, Medical Research CenterOulu University HospitalOuluFinland
- Translational Medicine Research UnitUniversity of OuluOuluFinland
| | - Outi Kuittinen
- Faculty of Health Medicine, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Department of Oncology and Radiotherapy, Medical Research CenterOulu University HospitalOuluFinland
- Translational Medicine Research UnitUniversity of OuluOuluFinland
- Länsi‐Pohja Central Hospital, Kauppakatu 25KemiFinland
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Harmanen M, Klaavuniemi T, Sorigue M, Khan M, Prusila R, Kari E, Alanne E, Rajamäki A, Sunela K, Jukkola A, Jantunen E, Sancho JM, Ketola S, Kuitunen H, Selander T, Rönkä A, Kuittinen O. Real-world Data: MCL2 Protocol Demonstrates Excellent Treatment Results Among Patients With Mantle Cell Lymphoma Not Fulfilling the Original Trial Inclusion Criteria. Hemasphere 2023; 7:e954. [PMID: 37693119 PMCID: PMC10489256 DOI: 10.1097/hs9.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Minna Harmanen
- Department of Oncology, Faculty of Health Medicine, Institute of Clinical Medicine, Kuopio University Hospital Cancer Center, Kuopio, Finland
| | - Tuula Klaavuniemi
- Department of Oncology, Mikkeli Central Hospital, Southern Savonia Municipality District, Mikkeli, Finland
| | - Marc Sorigue
- Department of Hematology, ICO-Badalona, Hospital Germans Trias i Pujol, IJC, LUMN, Badalona, Spain
| | - Madiha Khan
- Department of Oncology, Faculty of Health Medicine, Institute of Clinical Medicine, Kuopio University Hospital Cancer Center, Kuopio, Finland
| | - Roosa Prusila
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
- Cancer Center and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Esa Kari
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Erika Alanne
- Department of Oncology and Radiotherapy, Turku University Hospital, Western Finland, Cancer Center, Turku, Finland
| | - Aino Rajamäki
- Department of Oncology, Faculty of Health Medicine, Institute of Clinical Medicine, Kuopio University Hospital Cancer Center, Kuopio, Finland
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Oncology, Hospital Nova of Central Finland, Jyväskylä, Finland
| | - Kaisa Sunela
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Medicines Agency, Tampere, Finland
| | - Arja Jukkola
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Esa Jantunen
- Institute of Clinical Medicine, University of Eastern Finland and Department of Medicine, North Carelia Central Hospital, Joensuu, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Badalona, Hospital Germans Trias i Pujol, IJC, LUMN, Badalona, Spain
| | - Sanna Ketola
- Department of Oncology, Hospital Nova of Central Finland, Jyväskylä, Finland
| | - Hanne Kuitunen
- Cancer Center and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Tuomas Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Aino Rönkä
- Department of Oncology and Radiotherapy, Kuopio University Hospital, Kuopio, Finland
| | - Outi Kuittinen
- Department of Oncology, Faculty of Health Medicine, Institute of Clinical Medicine, Kuopio University Hospital Cancer Center, Kuopio, Finland
- Cancer Center and Medical Research Center, Oulu University Hospital, Oulu, Finland
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Harmanen M, Hujo M, Sund R, Sorigue M, Khan M, Prusila R, Klaavuniemi T, Kari E, Jantunen E, Sunela K, Rajamäki A, Alanne E, Kuitunen H, Sancho JM, Jukkola A, Rönkä A, Kuittinen O. Survival of patients with mantle cell lymphoma in the rituximab era: Retrospective binational analysis between 2000 and 2020. Br J Haematol 2022; 201:64-74. [PMID: 36513500 DOI: 10.1111/bjh.18597] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/27/2022] [Indexed: 12/15/2022]
Abstract
Mantle cell lymphoma (MCL) is a rare peripheral B-cell lymphoma characterised by eventual relapse and progression towards a more aggressive disease biology. With the introduction of rituximab- and cytarabine-based immunochemotherapy regimens, the prognosis of the disease has changed dramatically over the last two decades. To assess the real-world survival of patients with MCL, we used a population-based cohort of 564 patients with MCL who were diagnosed and treated between 2000 and 2020. Patient data were collected from seven Finnish treatment centres and one Spanish treatment centre. For the entire patient population, we report a 2-year overall survival (OS) rate of 77%, a 5-year OS of 58%, and a 10-year OS of 32%. The estimated median OS was 80 months after diagnosis. MCL is associated with increased mortality across the entire patient population. Additionally, we assessed the survival of patients after MCL relapse with the aim of establishing a cut-off point of prognostic significance. Based on our statistical analysis of survival after the first relapse, disease progression within 24 months of the initial diagnosis should be considered as a strong indicator of poor prognosis.
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Affiliation(s)
- Minna Harmanen
- Oncology, Faculty of Health Medicine, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mika Hujo
- Statistics, Faculty of Science and Forestry, School of Computing, University of Eastern Finland, Kuopio, Finland
| | - Reijo Sund
- Faculty of Health Medicine, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Marc Sorigue
- Department of Hematology, ICO-Badalona, Hospital Germans Trias i Pujol, IJC, Badalona, Spain
| | - Madiha Khan
- Oncology, Faculty of Health Medicine, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Roosa Prusila
- Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Esa Kari
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Esa Jantunen
- Department of Medicine, Hospital District of North Carelia, Institute of Clinical Medicine/Internal Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Kaisa Sunela
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Aino Rajamäki
- Department of Oncology, Hospital Nova of Central Finland, Jyväskylä, Finland.,Faculty of Health Medicine, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Erika Alanne
- Department of Oncology and Radiotherapy, Turku University Hospital, Western Finland Cancer Centre, Turku, Finland
| | - Hanne Kuitunen
- Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Badalona, Hospital Germans Trias i Pujol, IJC, Badalona, Spain
| | - Arja Jukkola
- Department of Oncology, Tampere University Hospital, Tampere Cancer Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Aino Rönkä
- Oncology, Faculty of Health Medicine, School of Medicine, Institute of Clinical Medicine, Kuopio University Hospital Department of Oncology, University of Eastern Finland, Kuopio, Finland
| | - Outi Kuittinen
- Oncology, Faculty of Health Medicine, School of Medicine, Institute of Clinical Medicine, Kuopio University Hospital Department of Oncology, University of Eastern Finland, Kuopio, Finland
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5
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Sorigue M, Bishton M, Domingo-Domenech E, McMillan A, Prusila R, García O, Kuusisto M, Condom M, Tapia G, Ribera JM, Kuittinen O, Fox CP, Sancho JM. Refractoriness to rituximab-based therapy and elevated serum B2-microglobulin predict for inferior survival in marginal zone lymphoma. Leuk Lymphoma 2019; 60:2524-2531. [PMID: 30942640 DOI: 10.1080/10428194.2019.1594212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Short responses to immunochemotherapy predict for an inferior OS in follicular lymphoma. We set out to determine whether this is also the case in marginal zone lymphoma. A group of 139 marginal zone lymphoma (MZL) patients treated with front-line immuno- or immunochemotherapy (I/ICT) were categorized into I/ICT-refractory (non-response or relapse/progression within six months of treatment response assessment) or I/ICT-sensitive. Twenty-three patients (17%) were refractory. Refractory patients had inferior OS (4-yr probabilities of 57% vs. 83%, p = .0003) as did those with beta2-microglobulin (B2M)>3 mg/L (4-yr probabilities of 80% vs. 100%, p = .0029). On multivariable analysis they both showed a borderline significant correlation with OS (p = .06 and .07, respectively). B2M > 3 mg/L was also an adverse prognostic factor for progression-free survival in both univariable (4-yr probability of 61% vs. 83%, p = .02) and multivariable analysis (HR 2.9, p = .02). In conclusion, B2M and refractoriness to I/ICT may identify patients with MZL at higher risk of inferior survival.
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Affiliation(s)
- Marc Sorigue
- Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Mark Bishton
- Department of Clinical Haematology, Nottingham University Hospitals NHS Trust , Nottingham , UK
| | | | - Andrew McMillan
- Department of Clinical Haematology, Nottingham University Hospitals NHS Trust , Nottingham , UK
| | - Roosa Prusila
- Department of Oncology, MRC, Oulu University Hospital , Oulu , Finland
| | - Olga García
- Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Milla Kuusisto
- Department of Oncology, North Karelia Central Hospital , Joensuu , Finland
| | - Maria Condom
- Department of Hematology, Hospital Duran i Reynals , Barcelona , Spain
| | - Gustavo Tapia
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Josep-María Ribera
- Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Outi Kuittinen
- Department of Oncology, MRC, Oulu University Hospital , Oulu , Finland
| | - Christopher P Fox
- Department of Clinical Haematology, Nottingham University Hospitals NHS Trust , Nottingham , UK
| | - Juan-Manuel Sancho
- Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona , Badalona , Spain
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Prusila R, Sorigue M, Tanhua T, Tikkanen S, Jantunen E, Kuittinen O, Karihtala P, Kuitunen H, Turpeenniemi-Hujanen T. RISK OF SECONDARY HEMATOLOGICAL MALIGNANCY IN PATIENTS WITH FOLLICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- R. Prusila
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
| | - M. Sorigue
- Department of Hematology; Hospital Universitari Germans Trias i Pujol; Badalona Spain
| | - T. Tanhua
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
| | - S. Tikkanen
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
| | - E. Jantunen
- Department of Medicine Kuopio; Kuopio University Hospital; Kuopio Finland
| | - O. Kuittinen
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
| | - P. Karihtala
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
| | - H. Kuitunen
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
| | - T. Turpeenniemi-Hujanen
- Department of Oncology and Radiotherapy; Medical Research Center of Oulu University Hospital; Oulu Finland
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