Outcomes and Utilization Trends of Front-Line Autologous Hematopoietic Cell Transplantation for Mantle Cell Lymphoma.

Although autologous hematopoietic cell transplantation (auto-HCT) has become a common practice for eligible patients in the front-line setting with mantle cell lymphoma (MCL), there are limited data regarding trends in auto-HCT utilization and associated outcomes. This study used the Center for International Blood and Marrow Transplant Research (CIBMTR) database to evaluate survival outcomes and auto-HCT utilization in adults age ≥18 years who underwent auto-HCT within 12 months of diagnosis of MCL between January 2000 and December 2018. The 19-year period from 2000 to 2018 was divided into 4 separate intervals-2000 to 2004, 2005 to 2009, 2010 to 2014, and 2015 to 2018-and encompassed 5082 patients. To evaluate transplantation utilization patterns, we combined MCL incidence derived from the SEER 21 database with CIBMTR- reported auto-HCT activity within 12 months of diagnosis of MCL. Primary outcomes included overall survival (OS) along with the auto-HCT utilization rate. The cumulative incidence of nonrelapse mortality at 1 year decreased from 7% in the earliest cohort (2000 to 2004) to 2% in the latest cohort (2015 to 2018). Mirroring this trend, OS outcomes improved continually with time, with a 3-year OS of 72% in the earliest cohort improving to 86% in the latest cohort. In addition, we noted an increase in auto-HCT utilization from 2001 to 2018, particularly in patients age ≤65 years. This large retrospective analysis highlights trends in auto-HCT utilization and outcomes in patients with MCL and emphasizes the need to optimize pretransplantation and post-transplantation treatment strategies to enhance survival outcomes.
Competing Interests: Conflict of interest statement P.A.R. reports research support/funding from Celgene/BMS, Kite Pharma, MorphoSys, Calibr, and Novartis Pharmaceuticals; speaker's bureau for Kite Pharma and Bayer; consultancy on advisory boards for Verastem Oncology, Novartis Pharmaceuticals, Celgene/BMS, BeiGene, Karyopharm Therapeutics, Takeda Pharmaceutical, and Bayer; and honoraria from Novartis Pharmaceuticals. M.H. reports research support/funding from Takeda Pharmaceutical, and Astellas Pharma; consultancy for Incyte, ADC Therapeutics, Celgene, Pharmacyclics, Magenta Therapeutics, Omeros, AbGenomics, Verastem, and TeneoBio; and speaker's bureau for Sanofi Genzyme and AstraZeneca. F.L. reports research support/funding from Kite Pharma; scientific advisor for Allogene, Amgen, bluebird bio, BMS/Celgene, Calibr, Celgene, GammaDelta Therapeutics, Iovance, Kite Pharma, Legend Biotech, Novartis, and Wugen; and consultancy for Cellular Biomedicine Group, Cowen Consulting, Gerson Lehrman Group, EcoR1, and Emerging Therapies. C.G.B. reports research support from Nant, BlueRock, and Fate Therapeutics and consulting for Allovir. T.N. reports research support from Karyopharm and Novartis. M.A.K.-D. reports consultancy for Daiichi Sankyo and Pharmacyclics. A.H. reports a consulting or advisory role for Bristol-Myers Squibb, Genentech/Roche, Merck, Seattle Genetics, and Karyopharm; research funding from Bristol-Myers Squibb, Genentech/Roche, Merck, Pharmacyclics, Seattle Genetics, and ADCT Therapeutics (all institutional); and travel, accommodations, and expenses from Bristol-Myers Squibb. C.S.S. reports research support/funding from Juno Therapeutics, Celgene, Bristol-Myers Squibb, Precision Biosciences, and Sanofi-Genzyme and consultancy on advisory boards for Juno Therapeutics, Sanofi-Genzyme, Spectrum Pharmaceuticals, Novartis, Genmab, Precision Biosciences, Kite Pharma, Celgene, Gamida Cell, Karyopharm Therapeutics, and GlaxoSmithKline. The other authors report no conflicts of interest.
(Copyright © 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)