{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:57:34Z","timestamp":1785585454682,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    First\u2010line therapy for mantle cell lymphoma (MCL) represents a critical opportunity for clinical benefit via sustained complete response. We conducted a phase 2 multicenter trial in the academic and community cancer research united (ACCRU) network, testing a multitargeted 1st line regimen. CARiBOU (ACCRU\u2010LY\u20101804) employs alternating VR\u2010CAP and R\u2010cytarabine with continuous acalabrutinib, in six 21\u2010day\u2009cycles, for previously untreated MCL. The primary endpoint was complete metabolic response (CMR) rate. Secondary endpoints included safety, feasibility of stem cell collection, proportion proceeding to ASCT, and progression\u2010free (PFS) and overall survival (OS). Peripheral blood measurable residual disease (MRD) was tested using the ClonoSEQ assay (Adaptive Biotechnologies). Of 41 patients enrolled, 39 (95%) responded to therapy, including 37 patients achieving CMR (90%). Two nonresponders discontinued therapy for toxicity early, prior to study\u2010defined restaging, and received alternate therapy. Undetectable MRD at a 10\n                    <jats:sup>6<\/jats:sup>\n                    threshold was achieved in 26\/33 tested patients (79%), and 94% at 10\n                    <jats:sup>5<\/jats:sup>\n                    . 18\u2010month estimated PFS is 79% (95% CI 64%\u201397%), and OS is 96% (95% CI 88%\u2013100%). Toxicities were primarily hematologic (grade 3 hematologic AE in 32 patients, [78%]). Twelve required platelet transfusions, and one grade 3 bleeding event occurred. Febrile neutropenia occurred in 4 patients, and 6 (14%) experienced SAEs. There were no treatment\u2010related deaths. CARiBOU is an efficient, highly effective outpatient 1st line MCL regimen, employing intermediate\u2010dose cytarabine and continuous acalabrutinib for 6\u2009cycles. This multitargeted regimen addresses the biologic heterogeneity of MCL and permits flexible MRD\u2010guided decisions on consolidation and maintenance.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    identifier: NCT04626791\n                  <\/jats:p>","DOI":"10.1002\/ajh.70406","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:15:03Z","timestamp":1781684103000},"page":"2190-2196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes From the Multicenter\n                    <scp>ACCRU<\/scp>\n                    \u2010\n                    <scp>LY<\/scp>\n                    \u20101804\/\n                    <scp>CARiBOU TRIAL<\/scp>\n                    (Cytarabine, Acalabrutinib and Rituximab Integrated With Bortezomib\u2010Based Outpatient Therapy) in\u00a01st Line Mantle Cell Lymphoma"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5354-7593","authenticated-orcid":false,"given":"Stephen D.","family":"Smith","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle WA USA"},{"name":"Division of Hematology and Oncology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Mount Sinai Icahn School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmila","family":"Giri","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials and Biostatistics Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Ness","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials and Biostatistics Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-8341","authenticated-orcid":false,"given":"Yucai","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3023-6834","authenticated-orcid":false,"given":"Ajay K.","family":"Gopal","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle WA USA"},{"name":"Division of Hematology and Oncology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Wake Forest University School of Medicine, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Tamar","family":"Tatoian","sequence":"additional","affiliation":[{"name":"Mount Sinai Icahn School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trenton","family":"Grossfeld","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle WA USA"},{"name":"Division of Hematology and Oncology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edus H.","family":"Warren","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle WA USA"},{"name":"Division of Hematology and Oncology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz S.","family":"Nowakowski","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven I.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Wake Forest University School of Medicine, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102024\u2010212973"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102141.2012.09174.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)00739\u2010X"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)00184\u20103"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102024\u2010194641"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13929"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010025\u201002787\u20100"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2018.10.006"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.8800"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412096"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0048"},{"key":"e_1_2_11_13_1","unstructured":"M. L.Wang \u201cMinimal Residual Disease With Bendamustine\u2010Rituximab With or Without Acalabrutinib in Patients With Previously Untreated Mantle Cell Lymphoma: Results From the Phase 3 Echo Trial \u201d(2025)."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102025\u2010884"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102024\u2010192939"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.8960"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01097"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO\u201025\u201000690"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02321"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201817"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2024000658"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.70406","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajh.70406","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.70406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:19:24Z","timestamp":1785583164000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.70406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ajh.70406"],"URL":"https:\/\/doi.org\/10.1002\/ajh.70406","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"2026-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}