Photo Credit: David A Litman
The following is a summary of “Conditional survival of younger patients with mantle cell lymphoma: Results from a randomized phase III trial of the European MCL Network,” published in the October 2024 issue of Hematology by Jiang et al.
Patients facing a severe illness often seek updates on their future survival outlook. In cases where patients have survived a specific duration, conditional survival helps estimate their upcoming survival chances. This study focused on conditional overall and failure-free survival in younger patients with mantle cell lymphoma (MCL), using data from a randomized phase III trial that compared R-CHOP and alternating R-CHOP/R-DHAP immunochemotherapies before autologous transplantation.
Researchers conducted a retrospective study investigating conditional survival probabilities for patients with MCL who have survived 1 to 8 years, examining factors like MIPI, Ki-67, and treatment failure status.
They analyzed data from 473 younger patients using the conditional Kaplan-Meier method and Cox regression to estimate survival probabilities after 1 to 8 years of survival. The study compared patients treated with R-CHOP and R-CHOP/R-DHAP, assessing how survival rates evolved.
The results showed that patients treated with R-CHOP started with lower survival rates but showed improved subsequent survival as they survived longer (5-year conditional survival at 72% after 1 year and 81% after 7 years). Patients treated with R-CHOP/R-DHAP, however, maintained stable future survival over time (77% after 1 year and 78% after 7 years). The prognostic power of MIPI decreased after 3 years for patients treated with R-CHOP but remained steady for those treated with R-CHOP/R-DHAP. Patients experiencing treatment failure had significantly lower survival compared to those in remission, regardless of the time they survived. Longer remission led to extended periods free of treatment failures.
Investigators concluded that these findings offer personalized insights for younger patients with MCL, allowing for dynamic prognosis and highlighting the importance of effective first-line treatments for improved survival.