EFFICACY OF 4 DIFFERENT REGIMENS IN 64 MANTLE-CELL LYMPHOMA CASES - CLINICOPATHOLOGICAL COMPARISON WITH 498 OTHER NON-HODGKINS-LYMPHOMA SUBTYPES

Purpose: Before recognizing mantle-cell lymphoma (MCL) as a distinct e ntity, these patients were grouped into low-grade (LG) or intermediate -/high-grade categories (IGHG) according to the Working Formulation an d received various therapies. This was a unique opportunity to evaluat e characteristics, behavior, response to treatment, and outcome of pat ients with MCL from two phase III trials conducted by the European Org anization for the Research and Treatment of Cancer (EORTC): EORTC 2085 5 IGHG and EORTC 20856 LG. Patients and Methods: After histologic revi ew, 64 diagnosed MCL patients (29 IGHG and 35 LG) were compared with o ther patients in their respective trials. In the IGHG group, patients received cyclophosphamide, doxorubicin, teniposide (VM(26)), prednison e, vincristine, and bleomycin (CHVmP-VB) or modified doxorubicin, cycl ophosphamide, etoposide (VP16), mechlorethamine, vincristine, procarba zine, and prednisone (ProMACE-MOPP). in the LG group, after receiving cyclophosphamide, vincristine, and prednisone (CVP) induction, patient s were randomized between maintenance treatment with interferon alfa-2 a (IFN) or no further treatment. Results: MCL patients compared with I GHG subtypes showed a similar overall survival and response rate, but shorter duration of response and progression-free survival. Comparing with LG patients, their response rate, duration of response, and progr ession-free survival showed no difference, while their overall surviva l wets nearly twice shorter. MCL patients treated with CHVmP-VB had th e longest survival. No treatment showed any significant improvement in terms of progression-free survival. Conclusion: These data confirm th at MCL represents a clinicopathologic entity, In terms of survival, it behaves like IGHG subtypes, while in terms of progression-free surviv al, it behaves like LG lymphoma. It is still not clear which first lin e treatment offers patients with MCL the best chance to obtain both a complete response (CR) and a long-term survival. (C) 1995 by American Society of Clinical Oncology.