First-line bendamustine plus rituximab (B-R) followed by autologous stem cell transplant (ASCT) and rituximab maintenance appears to be an effective treatment option for younger patients with mantle cell lymphoma (MCL), according to a retrospective analysis published in Blood Advances.

For this study, researchers evaluated real-world evidence to determine whether B-R yields similar clinical outcomes as R-CHOP/R-DHAP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone, dexamethasone, cytarabine, cisplatin) in a population of patients with MCL who had the possibility of proceeding to ASCT and rituximab maintenance.

Data from 329 patients were included; 97 patients received B-R, and 232 received R-CHOP/R-DHAP. The median age was 58 years in the B-R group and 56 years in the R-CHOP/R-DHAP group. Most patients (90% and 82%, respectively) had Ann Arbor stage IV disease, and a minority (14% and 31%, respectively) had B symptoms.

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After induction, the overall response rate was 90% in the B-R group and 94% in the R-CHOP/R-DHAP group. The complete response rate was 54% in both groups.

Most patients — 77% in the B-R group and 78% in the R-CHOP/R-DHAP group — proceeded to ASCT. Two percent of patients in the R-CHOP/R-DHAP group received rituximab maintenance, compared with 78% of patients in the B-R group.

Progression-free survival was similar between the groups (adjusted hazard ratio, 0.79; P = .4), and there were no significant differences between the groups for other endpoints.

Based on these results, the researchers concluded that B-R with ASCT and rituximab maintenance “may be a reasonable first-line strategy for younger, transplant-eligible patients with MCL.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of authors’ disclosures. 


Villa D, Hoster E, Hermine O, et al. Bendamustine or high-dose cytarabine-based induction with rituximab in transplant-eligible mantle cell lymphoma. Blood Adv. 2022;6(18):5285-5294. doi:10.1182/bloodadvances.2022007371

This article originally appeared on Hematology Advisor