Dr Jerkeman on Induction Chemoimmunotherapy Followed by High-dose Chemo and ASCT in Younger Patients With MCL

“This is a sign of what we call functional or clinical cure, and we actually believe that a high proportion of patients [with MCL] are cured with this treatment.”

Mats Jerkeman, MD, a professor in the Department of Oncology at Lund University in Sweden, discussed long-term outcomes from the phase 2 Nordic MCL2 (ISRCTN87866680) and MCL3 (NCT00514475) trials, which evaluated intensive, first-line induction chemoimmunotherapy regimens followed by consolidation with high-dose chemotherapy and autologous stem cell transplantation (ASCT) in younger patients with mantle cell lymphoma (MCL).

The analysis assessed whether survival outcomes in the trial population approached those of an age- and sex-matched general population from the Nordic countries. Jerkeman noted that, at a median follow-up of 18 years, no survival plateau was observed in the overall cohort; excess mortality was present even in patients who remained in first remission for more than 15 years after treatment, indicating that MCL continues to confer a long-term survival disadvantage at the population level.

Subgroup analyses revealed that patients aged 50 years or younger at diagnosis demonstrated a different survival pattern. In this patient subset, no excess mortality was observed compared with the matched general population, suggesting the potential for functional, or clinical, cure in selected patients. Jerkeman added that approximately 25% of all trial participants remained alive and in their first complete remission after 20 years, underscoring the durability of responses achievable with this treatment approach.

Overall, data from the MCL2 and MCL3 trials, which are counted among studies with the longest follow-up in MCL, emphasize both the curative potential of intensive frontline therapy and the ongoing need for vigilance in long-term survivors. Jerkeman explained that the persistence of excess mortality in the broader population reinforces the importance of continued surveillance, even for patients in prolonged remission, and underscores the need to address late relapses and long-term treatment-related toxicities.