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Rev. méd. Chile ; 147(1): 9-17, 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-991367

RESUMO

Background: Mantle cell lymphoma (MCL) has high relapse and mortality rates. There is a survival benefit when treatment is intensified with cytarabine (AraC), hematopoietic cell transplantation (HCT) and maintenance with rituximab. Aim: To assess the outcomes of patients with MCL treated in a university hospital. Material and Methods: Review of an oncology center database and medical records identifying patients with MCL treated between 2006 and 2017. Death dates were obtained from the death certificate database of the National Identification Service. We analyzed the response rate, overall survival (OS) and progression-free survival (PFS). As a secondary objective, the survival impact of AraC, HCT and maintenance with rituximab, was also analyzed. Results: Information on 20 patients aged 62 ± 11 years, followed for a median of 45 months was retrieved. Eighty-five percent were diagnosed at an advanced stage. The most used first-line regime was R-CHOP in 11 patients, followed by R-HyperCVAD in five. Only 47% achieved complete response. 4-year PFS and OS were of 30 and 77% respectively. Mantle Cell Lymphoma International Prognostic Index (MIPI) significantly predicted PFS and OS. Maintenance with rituximab or HCT was associated with better PFS (48 vs 21 months, p < 0.01). The exposure to AraC or HCT, in refractory or relapsed disease, was associated with an increase in PFS from 9 to 28 months (p = 0,02) and 4-year OS from 40 to 100% (p = 0.05). OS increased even more, from 25 to 100% in those with high-risk MIPI (p = 0.04). Conclusions: The incorporation of AraC, HCT and maintenance with rituximab in the therapeutic backbone of MCL, especially for high-risk cases, was associated with improved survival.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transplante de Células-Tronco Hematopoéticas/métodos , Linfoma de Célula do Manto/cirurgia , Linfoma de Célula do Manto/tratamento farmacológico , Citarabina/uso terapêutico , Rituximab/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Antimetabólitos Antineoplásicos/uso terapêutico , Fatores de Tempo , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Distribuição por Sexo , Terapia Combinada , Distribuição por Idade , Estatísticas não Paramétricas , Linfoma de Célula do Manto/mortalidade , Estimativa de Kaplan-Meier , Intervalo Livre de Progressão , Recidiva Local de Neoplasia
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