Deferred treatment is a safe and viable option for selected patients with mantle cell lymphoma

Abstract

Prospective identification of candidates for deferred therapy is not standardized and many patients receive immediate therapy regardless of risk. We conducted a retrospective, multi-center cohort analysis of MCL patients with comprehensive clinical data to examine the use and safety of deferred therapy for newly diagnosed patients. Previously untreated patients ≥18 years-old with MCL diagnosed in 1993–2015 at five academic sites were included. Of 395 patients, 72 (18%) received deferred therapy (defined as receipt of first treatment >90 days following initial diagnosis). Patients receiving deferred therapy were more likely to have an ECOG performance status of 0 (67 versus 44% p = .001), have no B symptoms (83 versus 65% p = .003) and have normal LDH levels at diagnosis (87 versus 55% p < .001). In multivariable analysis, deferred therapy was not associated with a significant difference in OS (HR 0.64: 95% CI 0.22–1.84, p = .407).

Keywords:

• Mantle cell lymphoma
• deferred therapy
• non-Hodgkin’s lymphoma

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1455973.

Additional information

Funding

This work received grant funding from the Lymphoma Research Foundation, the American Society of Hematology and National Cancer Institute. Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number 3P30CA138292-06S1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.