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T-cell replete allogeneic stem cell transplant for mantle cell lymphoma achieves durable disease control, including against TP53-mutated disease

Bone Marrow Transplantation volume 56, pages 2857–2859 (2021)Cite this article

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For patients with mantle cell lymphoma (MCL), frontline regimens incorporating rituximab, high-dose cytarabine and autologous (auto) stem cell transplantation (SCT) achieve a median progression-free survival (PFS) of 8.5 years and overall survival (OS) of 12.7 years [1].

However, the ~10% of patients with TP53-mutated disease have a dismal prognosis after intensive chemoimmunotherapy, with a median PFS of <1 year and median OS of 1.8 years. TP53 mutations were the only genetic lesion independently associated with inferior PFS and OS on multivariate analysis of patients treated in the Nordic MCL2/MCL3 trials [2], conferring inferior prognosis compared to TP53 deletions or isolated 17p deletions (del(17p)) [2, 3]. The poor outcomes in this subset warrant investigation of alternative strategies, including allogeneic (allo-)SCT, which can achieve long-term remissions in molecularly uncharacterized MCL [4].

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Fig. 1: Outcomes after allogeneic stem cell transplantation for patients with mantle cell lymphoma.

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Author notes

  1. These authors contributed equally: Thomas E. Lew, Edward R.S. Cliff.

Authors and Affiliations

  1. Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia

    Thomas E. Lew, Edward R. S. Cliff, Michael Dickinson, Constantine S. Tam, John F. Seymour, Piers Blombery, Ashish Bajel, David Ritchie & Amit Khot

  2. Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia

    Thomas E. Lew

  3. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia

    Michael Dickinson, Ashish Bajel, David Ritchie & Amit Khot

  4. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia

    Constantine S. Tam, John F. Seymour, Piers Blombery & David Ritchie

  5. Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

    Piers Blombery

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Contributions

TEL, DR and AK conceived of the project and designed the study; TEL, ERC, MD, CST, JFS, AB, DR, AK were responsible for patient care; PB contributed molecular data; TEL and ERC collected the data; TEL analyzed the data; PB performed and analyzed genomic data; TEL and ERC wrote the first version of the manuscript; and all authors reviewed the data and contributed to critical revision of the manuscript.

Corresponding author

Correspondence to Thomas E. Lew.

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Competing interests

TEL is an employee of the Walter and Eliza Hall Institute of Medical Research, which receives milestone and royalty payments related to venetoclax. TEL is a recipient of a share in royalty payments paid to the Walter and Eliza Hall Institute of Medical Research. TEL has received honoraria from AbbVie. CST has received honoraria and research funding from AbbVie and Janssen and honoraria from BeiGene. JFS receives research funding from AbbVie, Genentech, Celgene, and Janssen and is an advisory board member for and has received honoraria from AbbVie, Acerta, Celgene, Genentech, Janssen, Roche, Sunesis, and Takeda. AK has received honoraria from Janssen, Celgene, Kyowa, Kirin, and Amgen. AB has received honoraria from Novartis, Amgen, Astellas, Abbvie and speaker fees from Amgen. The remaining authors declare no competing financial interests.

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Lew, T.E., Cliff, E.R.S., Dickinson, M. et al. T-cell replete allogeneic stem cell transplant for mantle cell lymphoma achieves durable disease control, including against TP53-mutated disease. Bone Marrow Transplant 56, 2857–2859 (2021). https://doi.org/10.1038/s41409-021-01418-3

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