Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in TP53-mutated disease

Abstract

Cytarabine-containing chemoimmunotherapy followed by autologous transplantation and rituximab maintenance achieves durable remissions for most patients with mantle cell lymphoma (MCL). However, patients with TP53-mutated disease have poor outcomes with standard approaches. We previously reported that allogeneic stem cell transplantation (alloSCT) achieved durable remissions in MCL, however follow-up among patients with TP53-mutated disease was limited. Here we report extended follow-up of the overall cohort (n = 36) and TP53-mutated subset (n = 13) (median follow-up 10.8 and 4.2 years, respectively). Estimated overall survival was 56% at 10 years for the overall cohort and 59% at 4 years for the TP53-mutated subset. Among patients with TP53-mutated disease, no relapses occurred beyond 6 months post-transplant. Survival after post-alloSCT disease relapse was poor (median 2.1 years). These data confirm that alloSCT can be curative in MCL, including patients with TP53-mutated disease, and should be considered for earlier utilization in this subgroup for whom conventional chemoimmunotherapy is ineffective.

Keywords:

• Neoplasia
• lymphoma and hodgkin disease
• marrow and stem cell transpantation
• clinical results
• neoplasia
• molecular genetics

Author contributions

T.E.L., D.R. and A.K. conceived of the project and designed the study; T.E.L, E.R.S.C, M.D., C.S.T., J.F.S, A.B., D.R., A.K were responsible for patient care; P.B contributed molecular data; T.E.L., and E.R.S.C. collected the data; T.E.L. analyzed the data; P.B. performed and analyzed genomic data; T.E.L. and E.R.S.C wrote the first version of the manuscript; and all authors reviewed the data and contributed to critical revision of the manuscript.

Disclosure statement

TEL is an employee of the Walter and Eliza Hall Institute of Medical Research, which receives milestone and royalty payments related to venetoclax. TEL is a recipient of a share in royalty payments paid to the Walter and Eliza Hall Institute of Medical Research. TEL has received honoraria from AbbVie. ERSC’s research is funded by Arnold Ventures. MD has received research funding from Roche, Novartis, Gilead, and Takeda, and has received honoraria from Roche, AbbVie, GenMab, Novartis, Kite, Gilead, and Bristol Myers Squibb. CST has received honoraria and research funding from AbbVie and Janssen and honoraria from BeiGene. JFS receives research funding from AbbVie, Genentech, Celgene, and Janssen and is an advisory board member for and has received honoraria from AbbVie, Acerta, Celgene, Genentech, Janssen, Roche, Sunesis, and Takeda. AK has received honoraria from Janssen, Celgene, Kyowa, Kirin, and Amgen. AB has received honoraria from Novartis, Amgen, Astellas, Abbvie and speaker fees from Amgen. The remaining authors declare no competing financial interests.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.