Autologous hematopoietic cell transplant (auto-HCT) is just not useful for sufferers with mantle cell lymphoma (MCL) in first full remission (CR) with undetectable minimal residual illness (uMRD), in keeping with a examine to be offered on the annual assembly of the American Society of Hematology, held from Dec. 7 to 10 in San Diego.
Timothy S. Fenske, M.D., from the Medical School of Wisconsin in Milwaukee, and colleagues carried out a four-arm trial involving sufferers with MCL between 18 and 70 years of age and in first remission. Sufferers in CR with uMRD at 1 in 10-6 sensitivity (uMRD6) have been randomly assigned to arm A (auto-HCT + three years of upkeep rituximab [MR]) or arm B (three years of MR alone). Sufferers with MRD-positive CR or MRD-indeterminate CR each acquired auto-HCT + three years of MR (arms C and D, respectively). The first finish level was to match survival in arms A and B.
From August 2017 to July 2024, 257, 259, 49, and 85 sufferers have been enrolled in arms A, B, C, and D, respectively. The researchers discovered that the estimated general survival hazard ratios for arms A and B in all randomized and treated-as-assigned sufferers (516 and 375, respectively) have been 1.11 (95% confidence interval, 0.71 to 1.74; P = 0.66) and 1.00 (95% confidence interval, 0.58 to 1.74; P = 0.99), and crossed the boundary for futility. Three-year general survival was 82.1 and 82.7%, respectively, for arms A and B in all randomly assigned sufferers, and 86.2 and 84.8%, respectively, in these handled as assigned.
“In this interim analysis, in the era of highly effective induction and maintenance regimens, MCL patients in first CR with uMRD6 did not benefit from consolidative auto-HCT,” the authors write.
A number of authors disclosed ties to the pharmaceutical and biotechnology industries.
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