Better chances of survival for patients with rare form of lymphoma

The chances of survival for older patients (60+) with mantle cell lymphoma, a rare subset of non-Hodgkin lymphoma increase if they continue with a maintenance dose of the drug rituximab after chemotherapy. The discovery was made by a group of European researchers led by UMCG haematologist Prof. Hanneke Kluin-Nelemans. The results of their study are published in this week’s edition of The New England Journal of Medicine. ‘This European study shows just how much we can achieve if we join forces in the search for better treatment for rare forms of cancer,’ says Prof. Kluin-Nelemans.

Mantle cell lymphoma is a rare form of non-Hodgkin lymphoma, and occurs characteristically in older men. Half of these patients are over 60-65 years old. The majority of patients present with extensive disease.

European network

Until recently, the prognosis for people diagnosed with mantle cell lymphoma was poor. In the 1990s, a group of haematologists set up a European network with the aim of pooling research on mantle cell lymphoma. ‘The number of patients per country was too low to warrant individual research programmes. So we compiled a joint database with data from patients in eight countries. It turned out that only half of these people were surviving 3 years after treatment’, explains Prof. Kluin-Nelemans. The group of haematologists conducted various studies aiming at improving the treatment for mantle cell lymphoma. The study supporting this current report was funded by the European Union.

Better survival rate

A total of 560 patients took part in the study. Those who responded well to the initial chemotherapy were subsequently treated with a maintenance dose of the antibody rituximab, consisting of only one dose every two months. The effects of the drug rituximab were compared with those of interferon-alfa. The 4-year survival rate among patients on a maintenance dose of rituximab was 58%, while the rate for the group treated with interferon-alfa was 29%. In the most ‘promising’ group, i.e. the patients who had responded best to the initial chemotherapy, the 4-year survival rate on rituximab was as high as 87%, which was unbelievable good for a group of patients with such a poor outcome in the recent past. ‘This is the first time that a large-scale study of older patients with mantle cell lymphoma has been carried out. We are now able to offer them much better treatment than we could before,’ says Prof. Kluin-Nelemans.

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