Improvement of Overall Survival in Mantle Cell Lymphoma during the Last Decades.

Purpose: Mantle cell lymphomas (MCL) represent a lymphoma subtype with an especially poor long term prognosis. Although various therapy strategies have been applied within the last 30 years, MCL is still considered incurable by conventional chemotherapy.

Patients and methods: To determine whether patient outcome has improved during the last decades, we compared data from the “Kiel lymphoma group” (KLG) collected in the years 1975–1986 with data from the “German lymphoma study group” (GLSG) of the years 1996–2004. To minimize potential heterogeneity of risk profiles of the two patient populations, frequency matching was pursued. Additionally, the effects of other potential prognostic parameters were adjusted by a Cox proportional hazard model.

Results: A total of 520 patients were evaluable for analysis. The median overall survival significantly increased from 2.7 years up to 4.8 years (p<0.0001; hazard ratio (HR) 0.44) and 5-year-survival of advanced MCL more than doubled from 22% [95% CI, 13% to 31%] to 47% [95% CI, 38% to 55%]. Multivariate analysis identified a poor performance status (HR 2.26), a high LDH level (HR 1.75), and age (HR 1.38) as additional prognostic variables.

Conclusion: Patients with advanced MCL benefit from the progress of medical treatment resulting in almost doubling of overall survival during the last 3 decades, even though relapses are regularly observed.