Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in TP53 -mutated disease.
Thomas E LewEdward Robert Scheffer CliffMichael J DickinsonConstantine S TamJohn Francis SeymourPiers A BlomberyAshish BajelDavid S RitchieAmit KhotPublished in: Leukemia & lymphoma (2023)
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.