Minimal residual disease (MRD) status prior to autologous stem cell transplantation (autoSCT) is an early predictor of progression-free survival (PFS) and overall survival (OS) in younger patients with mantle cell lymphoma (MCL), according to a study presented at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition.
This study was presented by Mary Callanan, PhD, University Hospital F. Mitterrand and Inserm, Dijon, France.
“[MRD] has emerged as an important predictor of clinical outcome in patients with [MCL]. Its use in everyday clinical practice, however, remains uncertain since standardized MRD monitoring strategies and response criteria are not yet formally established,” she explained.
This analysis aimed to assess MRD response rates and prognostic impact among patients on the LyMa trial. Patients in this trial received 4 courses of R-DHAP followed by autoSCT. After autoSCT, patients were randomized to observation or rituximab maintenance.
An additional aim was to assess the value of combining molecular MRD and PET for outcome prediction pre- and post-ASCT.
A total of 195 MRD evaluable patients were included in the analysis. Pre-autoSCT, negative MRD was reported in 77% (144) of peripheral blood samples and 64% (n = 115) bone marrow samples. MRD status prior to autoSCT was predictive of PFS (peripheral blood, P <.0001; bone marrow, P = .0295) and OS (P <.0001 and P = .0407, respectively).
Post-autoSCT, MRD was negative in 181 (94%) of peripheral blood samples and 137 (81%) bone marrow samples and was predictive of PFS (P = .0452 and P = .0261, respectively).
Combining PET and MRD status offered improved prediction of PFS both pre- and post-autoSCT. Similarly, combining either pre- or post-autoSCT PET/MRD also provided improved prediction of OS.
“Pre-autoSCT MRD status in both bone marrow and peripheral blood is an early predictor of PFS and OS in younger MCL patients receiving autoSCT,” Dr Callanan concluded.
“Early sequential MRD monitoring at the pre-autoSCT treatment phase and directly post-autoSCT thus offers strong potential for early clinical outcome prediction, as a surrogate clinical end point, and for MRD-guided, risk-adapted treatment in MCL,” she added.—Janelle Bradley
Callanan MB, Macintyre E, Delfau-Larue MH, Thieblemont C. Predictive Power of Early, Sequential MRD Monitoring in Peripheral Blood and Bone Marrow in Patients with Mantle Cell Lymphoma Following Autologous Stem Cell Transplantation with or without Rituximab Maintenance; Final Results from the LyMa-MRD Project, Conducted on Behalf of the Lysa Group. Presented at: the 62nd ASH Annual Meeting and Exposition; Dec 5-8, 2020. Abstract 120.
