Nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) provides a long-term survival benefit for patients with relapsed MCL, including those with refractory disease or multiple relapses, according to a study of 70 patients with mantle cell lymphoma (MCL) who were treated with allogenic HCT after conditioning with 2 Gy of total body irradiation, with or without fludarabine and/or rituximab. Researchers found:

• 5-year nonrelapse mortality incidence was 28%.

• Relapse rate was 26%.

• 5-year overall survival (OS) rate was 55%.

• 5-year rate progression-free survival (PFS) rate was 46%.

• 80% of patients were off immunosuppression at last followup.

• Presence of relapsed or refractory disease predicted higher relapse; hazard ratio (HR), 2.94.

• OS rates at 5 and 10 years were comparable between patients with relapsed/refractory disease and those undergoing transplantation with partial or complete remission.

• High-risk cytomegalovirus (CMV) status was the only predictor of worse OS (HR, 2.32).

• High-risk CMC status and low CD3 dose predicted PFS (HR, 2.22).

Citation: Vaughn JE, Sorror ML, Storer BE, et al. Long-term sustained disease control in patients with mantle cell lymphoma with or without active disease after treatment with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. [Published online ahead of print July 24, 2015]. Cancer. doi. 10.1002/cncr.29498.