Abstract
BACKGROUND: Over the past 20 years, many novel agents and treatment regimens have been developed to treat mantle cell lymphoma (MCL). This study aimed to determine the impact of these new regimens on the survival of MCL patients from 1995 to 2013. METHODS: All newly diagnosed adult MCL patients in the Surveillance, Epidemiology, and End Results (SEER) and Texas Cancer Registry (TCR) databases were included. Patients were grouped into 4 calendar periods based on the time when new novel agents became available: chemotherapy-only (1995-1998, P1), rituximab + chemotherapy (1999-2004, P2), bortezomib and HyperCVAD (2005-2008, P3), bendamustine and Nordic regimen (2009-2013, P4). Associations between these time periods and survival outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazard regressions. RESULTS: A total of 7,555 SEER patients and 2,055 TCR patients were identified. All-cause mortality rates decreased significantly from 1995 to 2013 (SEER, P < 0.001; TCR, P = 0.03). Multivariable analysis of SEER data showed that the risk of MCL-specific death decreased significantly over the study period with hazard ratios of 0.82 (P2 vs. P1), 0.66 (P3 vs. P1), and 0.58 (P4 vs. P1) (P < 0.0001). Similar results were observed for TCR data (P < 0.0001). In an analysis stratified by tumor stage, only patients with advanced- stage tumors showed a significantly decreased risk of death in both SEER (P < 0.0001) and TCR (P = 0.002) datasets. CONCLUSION: Survival outcome for MCL patients improved from 1995 to 2013, especially for patients with advanced-stage tumors, potentially reflecting the impact of the introduction of novel agents and new therapeutic regimens.