Abstract
Objective:The efficacy and the safety of bortezomib-based chemotherapy were characterized in mantle cell lymphoma (MCL) patients.Materials and Methods:The PubMed, Cochrane Library, Clinical Key, Science Direct, Oxford Journals, and China National Knowledge Internet databases were searched up to 1 May 2019. The selected trials needed to match the inclusion criteria and be carried out to evaluate quality appraisal and the synthesis of efficacy and safety. The enrolled MCL patients using bortezomib-based chemotherapy or chemotherapy alone needed to have been compared. The overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were combined to evaluate the efficacy while serious adverse events (SAEs) (grade III-IV peripheral neuropathy, neutropenia, and infection) were used to evaluate the safety. The heterogeneity of the results were analyzed simultaneously.Results:A total of 620 patients were enrolled across four studies in our meta-analysis, and the pooled results showed that the PFS [hazard ratio (HR)=0.66, 95% confidence interval (CI)=0.54-0.82; p=0.0001)] and OS (HR=0.73, 95% CI=0.55-0.96; p=0.03) of patients with bortezomib-based chemotherapy were better than those of patients with chemotherapy alone, unlike ORR (risk ratio=1.46, 95% CI=0.85-2.49; p=0.17), while SAEs were prominent in the combination group.Conclusion:MCL patients who are ineligible for transplant or high-dose chemotherapy could benefit from bortezomib-based chemotherapy.
Highlights
Mantle cell lymphoma (MCL) is an aggressive, incurable subtype of non-Hodgkin B cell lymphoma [1,2,3], with cyclin D1 overexpression resulting from t(11;14) (q13;q32) translocation [4,5]
A total of 620 patients were enrolled across four studies in our meta-analysis, and the pooled results showed that the progression-free survival (PFS) [hazard ratio (HR)=0.66, 95% confidence interval (CI)=0.54-0.82; p=0.0001)] and overall survival (OS) (HR=0.73, 95% CI=0.55-0.96; p=0.03) of patients with bortezomib-based chemotherapy were better than those of patients with chemotherapy alone, unlike overall response rate (ORR), while serious adverse events (SAEs) were prominent in the combination group
mantle cell lymphoma (MCL) patients who are ineligible for transplant or high-dose chemotherapy could benefit from bortezomib-based chemotherapy
Summary
Mantle cell lymphoma (MCL) is an aggressive, incurable subtype of non-Hodgkin B cell lymphoma [1,2,3], with cyclin D1 overexpression resulting from t(11;14) (q13;q32) translocation [4,5]. High-dose chemotherapy with or without consolidation followed by autologous hematopoietic stem cell transplantation (ASCT) is the firstline treatment for MCL patient [2]. For patients not suitable for high-dose chemotherapy or transplant, reduced-dose chemotherapy is recommended [1,2,4]. The median failure-free survival for standard therapy is only 8 to 20 months and the median survival of patients with highintensity chemotherapy is 3-4 years [6]. Ibrutinib obtained the most significant effects with over 60% overall response rate (ORR) and almost 20% complete remission (CR) in relapsed/refractory (R/R) MCL [7], but it is not widely available for patients in developing countries with expensive costs. Lenalidomide did not benefit MCL patients with the minimum ORR and CR in R/R MCL [8]
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