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Dreyling M, Aurer I, Cortelazzo S, Hermine O, Hess G, Jerkeman M, Le Gouill S, Ribrag V, Trněný M, Visco C, Walewski J, Zaja F, Zinzani PL. Treatment for patients with relapsed/refractory mantle cell lymphoma: European-based recommendations. Leuk Lymphoma 2017; 59:1814-1828. [DOI: 10.1080/10428194.2017.1403602] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Martin Dreyling
- Medizinische Klinik und Poliklinik III, Klinikum der Universität München, LMU München, Germany
| | - Igor Aurer
- Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Olivier Hermine
- Department of Adult Haematology, Paris Descartes University, Paris, France
| | - Georg Hess
- University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | - Mats Jerkeman
- Department of Oncology, Lund University, Lund, Sweden
| | | | | | - Marek Trněný
- General Hospital, Charles University, Praha, Czech Republic
| | | | - Jan Walewski
- Maria Sklodowska-Curie Institute Oncology Centre, Warszawa, Poland
| | - Francesco Zaja
- Clinica Ematologica, Centro Trapianti e Terapie Cellulari “Carlo Melzi,” University of Udine, Udine, Italy
| | - Pier Luigi Zinzani
- Institute of Hematology “Seràgnoli,” University of Bologna, Bologna, Italy
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High-dose cytarabine does not overcome the adverse prognostic value of CDKN2A and TP53 deletions in mantle cell lymphoma. Blood 2015; 126:604-11. [DOI: 10.1182/blood-2015-02-628792] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/24/2015] [Indexed: 12/25/2022] Open
Abstract
Key Points
CDKN2A and TP53 deletions remain of bad prognostic value in younger MCL patients treated according to the current standard of care. CDKN2A and TP53 deletions have independent deleterious effects and should be considered for treatment decisions in addition to MIPI and Ki-67 index.
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Dreyling M, Geisler C, Hermine O, Kluin-Nelemans HC, Le Gouill S, Rule S, Shpilberg O, Walewski J, Ladetto M. Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 25 Suppl 3:iii83-92. [PMID: 25210087 DOI: 10.1093/annonc/mdu264] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- M Dreyling
- Department of Medicine III, University of Munich, Munich, Germany
| | - C Geisler
- Hematology Clinic, Rigshospitalet, Copenhagen, Denmark
| | - O Hermine
- Department of Hematology, Imagine Institute and Descartes University, INSERM U1163 and CNRS ERL 8564, Necker Hospital, Paris, France
| | - H C Kluin-Nelemans
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - S Le Gouill
- Service d'hématologie Clinique, CHU de Nantes, Université de Nantes, Nantes, France
| | - S Rule
- Peninsula School of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - O Shpilberg
- Institute of Hematology, Assuta Medical Center, Tel-Aviv, Israel
| | - J Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Institute and Oncology Centre, Warsaw, Poland
| | - M Ladetto
- Divisione di Ematologia, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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Combination of lenalidomide with vitamin D3 induces apoptosis in mantle cell lymphoma via demethylation of BIK. Cell Death Dis 2014; 5:e1389. [PMID: 25165875 PMCID: PMC4454319 DOI: 10.1038/cddis.2014.346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/10/2014] [Accepted: 07/21/2014] [Indexed: 02/07/2023]
Abstract
Mantle cell lymphoma (MCL) is a currently incurable B-cell malignancy.
Lenalidomide (Len) has been demonstrated to be one of the most efficient new
treatment options. Because Len and 1α,25-dihydroxyvitamin (VD3) synergize
to kill breast cancer cells, we investigated whether VD3 could increase the
ability of Len to induce MCL cell death. While MCL cells were weakly sensitive
to Len (1 μM), the addition of VD3 at physiological dose
(100 nM) strongly increased cell death, accompanied by slowdown in cell
cycle progression in MCL cell lines (n=4 out of 6) and primary
samples (n=5 out of 7). The Len/VD3 treatment markedly
increased the expression of the BH3-only BCL2-interacting killer (Bik) without
affecting the expression of other Bcl-2 molecules. Immunoprecipitation assays
demonstrated that Bik was free from anti-apoptotic partners, Bcl-2 and
Bcl-xL, in treated cells. Moreover, silencing of BIK
prevented apoptosis induced by Len/VD3, confirming the direct involvement of
Bik in cell death. Bik accumulation induced by Len/VD3 was related to an
increase in BIK mRNA levels, which resulted from a demethylation of
BIK CpG islands. The sensitivity of MCL cells to Len/VD3 was
similar to the response to 5-azacytidine, which also induced demethylation of
BIK CpG islands. These preclinical data provide the rationale to
investigate the role of VD3 in vivo in the response to Len.
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Autologous stem cell transplantation in mantle cell lymphoma: a report from the SFGM-TC. Ann Hematol 2013; 93:233-42. [DOI: 10.1007/s00277-013-1860-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
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Coiffier B. Clinical efficacy and management of temsirolimus in patients with relapsed or refractory mantle cell lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 13:351-9. [PMID: 23763923 DOI: 10.1016/j.clml.2013.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 04/10/2013] [Accepted: 04/17/2013] [Indexed: 11/30/2022]
Abstract
Most patients with mantle cell lymphoma (MCL) relapse within a few years of treatment. Conventional agents provide little benefit, thus identification of new therapies is critical to improve patient outcomes. Temsirolimus, an inhibitor of mammalian target of rapamycin, is an effective, well-tolerated option authorized in Europe for treatment of patients with relapsed/refractory MCL. Intravenous temsirolimus has been extensively studied in MCL and has consistently demonstrated single-agent antitumor activity. In the pivotal phase III trial, treatment with temsirolimus 175 mg weekly for 3 weeks followed by 75 mg weekly (175/75 mg) resulted in significant improvements in progression-free survival (P = .0009) and objective response rate (P = .002) vs. investigator's choice of therapy. Hematologic toxicities (thrombocytopenia, neutropenia) were the principal grade 3/4 adverse events associated with temsirolimus 175/75 mg. Other toxicities included increases in serum cholesterol and triglycerides, hyperglycemia, fatigue, and dyspnea. Overall, the safety profile of temsirolimus is acceptable in this setting, and most toxicities are manageable with dose modification or medical intervention. Clinical studies of temsirolimus in relapsed or refractory MCL patients aim to clarify the optimal treatment schedule and to assess rational combinations with other therapeutic agents, such as rituximab or chemotherapy. Practical considerations are discussed for the clinical use of temsirolimus in patients with MCL.
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Affiliation(s)
- Bertrand Coiffier
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Benite, France.
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Dreyling M, Thieblemont C, Gallamini A, Arcaini L, Campo E, Hermine O, Kluin-Nelemans JC, Ladetto M, Le Gouill S, Iannitto E, Pileri S, Rodriguez J, Schmitz N, Wotherspoon A, Zinzani P, Zucca E. ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. Ann Oncol 2013; 24:857-77. [PMID: 23425945 DOI: 10.1093/annonc/mds643] [Citation(s) in RCA: 223] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To complement the existing treatment guidelines for all tumour types, ESMO organizes consensus conferences to focus on specific issues in each type of tumour. In this setting, a consensus conference on the management of lymphoma was held on 18 June 2011 in Lugano, next to the 11th International Conference on Malignant Lymphoma. The conference convened ∼30 experts from all around Europe, and selected six lymphoma entities to be addressed; for each of them, three to five open questions were to be addressed by the experts. For each question, a recommendation should be given by the panel, referring to the strength of the recommendation based on the level of evidence. This consensus report focuses on the three less common lymphoproliferative malignancies: marginal zone lymphoma, mantle cell lymphoma, and peripheral T-cell lymphomas. A first report had focused on diffuse large B-cell lymphoma, follicular lymphoma, and chronic lymphocytic leukaemia.
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Affiliation(s)
- M Dreyling
- Department of Medicine III, University Hospital, LMU Munich, Germany.
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Li ZM, Zucca E, Ghielmini M. Open questions in the management of mantle cell lymphoma. Cancer Treat Rev 2013; 39:602-9. [PMID: 23415066 DOI: 10.1016/j.ctrv.2012.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 12/28/2012] [Accepted: 12/31/2012] [Indexed: 11/25/2022]
Abstract
Mantle cell lymphoma (MCL) is one of the lymphomas with the worse prognosis (median survival 3-5years) as it has an aggressive evolution and at the same time is incurable. Biologically it is characterized by the t(11;14)(q13;q32) translocation leading to overexpression of cyclin D1. This review focuses on a number of controversial issues in the management of this disease, as how to stage patients with a disease which often has extranodal localizations, how to recognize the small subgroup of cases with an indolent course, which treatment is suggested for the young and fit or for the elderly, the role of CNS prophylaxis, rituximab maintenance and radiotherapy, the indications to allogeneic transplantation and the place of new active anti-lymphoma drugs.
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Affiliation(s)
- Zhi-Ming Li
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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Kluin-Nelemans HC, Hoster E, Hermine O, Walewski J, Trneny M, Geisler CH, Stilgenbauer S, Thieblemont C, Vehling-Kaiser U, Doorduijn JK, Coiffier B, Forstpointner R, Tilly H, Kanz L, Feugier P, Szymczyk M, Hallek M, Kremers S, Lepeu G, Sanhes L, Zijlstra JM, Bouabdallah R, Lugtenburg PJ, Macro M, Pfreundschuh M, Procházka V, Di Raimondo F, Ribrag V, Uppenkamp M, André M, Klapper W, Hiddemann W, Unterhalt M, Dreyling MH. Treatment of older patients with mantle-cell lymphoma. N Engl J Med 2012; 367:520-31. [PMID: 22873532 DOI: 10.1056/nejmoa1200920] [Citation(s) in RCA: 361] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The long-term prognosis for older patients with mantle-cell lymphoma is poor. Chemoimmunotherapy results in low rates of complete remission, and most patients have a relapse. We investigated whether a fludarabine-containing induction regimen improved the complete-remission rate and whether maintenance therapy with rituximab prolonged remission. METHODS We randomly assigned patients 60 years of age or older with mantle-cell lymphoma, stage II to IV, who were not eligible for high-dose therapy to six cycles of rituximab, fludarabine, and cyclophosphamide (R-FC) every 28 days or to eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 21 days. Patients who had a response underwent a second randomization to maintenance therapy with rituximab or interferon alfa, each given until progression. RESULTS Of the 560 patients enrolled, 532 were included in the intention-to-treat analysis for response, and 485 in the primary analysis for response. The median age was 70 years. Although complete-remission rates were similar with R-FC and R-CHOP (40% and 34%, respectively; P=0.10), progressive disease was more frequent with R-FC (14%, vs. 5% with R-CHOP). Overall survival was significantly shorter with R-FC than with R-CHOP (4-year survival rate, 47% vs. 62%; P=0.005), and more patients in the R-FC group died during the first remission (10% vs. 4%). Hematologic toxic effects occurred more frequently in the R-FC group than in the R-CHOP group, but the frequency of grade 3 or 4 infections was balanced (17% and 14%, respectively). In 274 of the 316 patients who were randomly assigned to maintenance therapy, rituximab reduced the risk of progression or death by 45% (in remission after 4 years, 58%, vs. 29% with interferon alfa; hazard ratio for progression or death, 0.55; 95% confidence interval, 0.36 to 0.87; P=0.01). Among patients who had a response to R-CHOP, maintenance therapy with rituximab significantly improved overall survival (4-year survival rate, 87%, vs. 63% with interferon alfa; P=0.005). CONCLUSIONS R-CHOP induction followed by maintenance therapy with rituximab is effective for older patients with mantle-cell lymphoma. (Funded by the European Commission and others; ClinicalTrials.gov number, NCT00209209.).
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Affiliation(s)
- H C Kluin-Nelemans
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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