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

Leuk Lymphoma. 2023 Nov-Dec;64(11):1792-1800. doi: 10.1080/10428194.2023.2241095. Epub 2023 Aug 2.

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; clinical results; lymphoma and hodgkin disease; marrow and stem cell transpantation; molecular genetics; neoplasia.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Lymphoma, Mantle-Cell* / drug therapy
  • Lymphoma, Mantle-Cell* / therapy
  • Neoplasm Recurrence, Local
  • Rituximab / therapeutic use
  • Stem Cell Transplantation
  • Transplantation, Autologous
  • Tumor Suppressor Protein p53 / genetics

Substances

  • Rituximab
  • TP53 protein, human
  • Tumor Suppressor Protein p53