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R. Gressin et al.
highly predictive for PFS or OS whether determined at the mid-term staging or at the end of treatment. There were no survival differences (PFS or OS) between patients in partial or complete remission. Neither mid-term nor final FDG- PET scan responses were predictive for PFS or OS. The most highly predictive factor for PFS and OS (P<0.0001) was MRD status in peripheral blood at the end of treat- ment (Figure 2C, right panel and Table 2). Molecular blood MRD status at mid-term was also significant for PFS (P=0.01) and weakly significant for OS (P=0.047) (Table 2). By contrast, MRD status in the bone marrow after four cycles of treatment (mid-term) or at the end of treatment
was not predictive for either PFS or OS (see Online Supplementary Figure S3 for end-of-treatment data). The 4- year OS for patients who were MRD-negative in blood at the end of treatment (n=47/54) was 86.6% compared to 28.6% for blood MRD-positive patients (n=7/54).
Continued molecular remission status in the peripheral blood after therapy (at the 12-month follow-up) was signif- icantly associated with longer PFS (33 patients; 4-year PFS 97%). By contrast, the median PFS for patients who remained MRD-positive (n=6) or who had converted to an MRD-positive status in the peripheral blood by the 12- month follow-up (n=7) was 11 and 26 months, respectively.
AB
C
Figure 2. Survival of patients with mantle cell lymphoma following frontline treatment with the RiBVD regimen. (A) Progression-free survival of the 74 patients. (B) Overall survival of the 74 patients (C) Molecular response rates and overall survival according to molecular residual disease (MRD) status in peripheral blood after six cycles of RiBVD (treatment end).
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haematologica | 2019; 104(1)