A new statistical study of 520 mantle cell lymphoma (MCL) patients showed significant improvement in overall survival over the past three decades. The researchers list improved chemotherapy drugs, lower infection rates and a better understanding of the disease among the main reasons for this improvement.

Wolfgang Hiddemann, MD, PhD and Martin Dreyling, MD, PhD, a 2007 LRF MCL grantee and Mantle Cell Lymphoma Consortium executive committee member, of the University of Munich published their findings in The American Journal of Hematology/Oncology Friday. The patients analyzed were out of two study groups – the Kiel Lymphoma Study Group (KLSG) and the German Low Grade Lymphoma Study Group (GLSG), with data collected between 1975-1986 and 1996-2004, respectively. They found that overall survival increased to 4.8 years from 2.7 years in the time period between the two groups. Five-year survival doubled from 22 percent to 44 percent.

MCL was once viewed by many as an indolent disease, and the typical treatments were not as vigorous as they are today. Approaches from the 1970s that used chlorambucil and prednisone or cyclophosphamide, vincristine and prednisone (COP) were supplemented with doxorubicin to create more aggressive treatment schemes (cyclophosphamide, vincristine, prednisone and doxorubicin, or CHOP). Modern regimens include the anti-CD20 antibody rituximab. Also, now younger patients in remission often undergo myeloablative radiochemotherapy with autologous stem-cell transplantation.

These and other aggressive approaches, the researchers think, have led to the increase in survival through the years. Improvement in overall medical care has led to lower infection rates, and the researchers speculate that this has led to greater patient compliance with treatment regimens. Also, CT scans are more sensitive, leading to better staging diagnoses of MCL. This is thought to be a great enhancement since the majority of MCL patients present with advanced-stage disease; physicians can more accurately treat them.

"This study proves that the recent advances in clinical care have changed the previously frightening fate of mantle cell lymphoma into a frequently treatable disease that may be controlled for many years," Dr. Dreyling said. Although the disease is still considered noncurative and the researchers still necessitate continued MCL research, the results of this statistical survey are exciting and show the fruit of what decades of dedicated scientific research can yield.

December 16, 2009