{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:12:39Z","timestamp":1787317959098,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","award":["CAN 222167Pj"],"award-info":[{"award-number":["CAN 222167Pj"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Relapsed or refractory mantle cell lymphoma (R\/R MCL) remains difficult to treat, with outcomes dependent on the treatment regimen and remission duration after first\u2010line therapy. Several non\u2010chemotherapeutic regimens are under evaluation in R\/R, but few studies report long\u2010term outcomes. In this study, we present the long\u2010term outcomes of the 50 patients treated with ibrutinib, lenalidomide, and rituximab (IR2) in the Nordic Lymphoma Group MCL6 Philemon phase 2 trial. Survival outcomes were compared with a matched cohort from the Swedish MCL\n                    <jats:italic>complete<\/jats:italic>\n                    study. After 5 years, 14 patients (28%) remained relapse\u2010free, including one with a\n                    <jats:italic>TP53<\/jats:italic>\n                    mutation. The median progression\u2010free survival (PFS) was 17.4 months, with the longest PFS of 8.1 years. Thirty\u2010two patients had died, primarily from MCL (72%). Poorer survival was associated with intermediate or high\u2010risk Mantle Cell Lymphoma International Prognostic Index and impaired health\u2010related quality of life (HRQoL). While\n                    <jats:italic>TP53<\/jats:italic>\n                    mutations (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911) did not significantly impact survival, a trend toward poorer outcomes was observed in multivariable Cox regression analyses (PFS hazard ratio: 2.09, 95% confidence interval: 0.95\u20134.62,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.068). The IR2 regimen demonstrated superior survival compared to the MCL\n                    <jats:italic>complete<\/jats:italic>\n                    cohort both before and after matching. In conclusion, this study highlights the role of non\u2010chemotherapeutic agents in R\/R MCL and demonstrates the prognostic impact of HRQoL on overall survival. Although IR2 showed initial activity in TP53\u2010mutated patients, it did not completely overcome their poor prognosis. However, the IR2 regimen may serve as a bridge to allogeneic stem cell transplantation or chimeric antigen receptor T\u2010cell therapy.\n                  <\/jats:p>","DOI":"10.1002\/hem3.70101","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T05:39:48Z","timestamp":1742276388000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ibrutinib, lenalidomide, and rituximab in relapsed mantle cell lymphoma: Long\u2010term follow\u2010up of the Nordic Lymphoma Group MCL6 Philemon trial"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0837-7410","authenticated-orcid":false,"given":"Elin","family":"Forsgren","sequence":"first","affiliation":[{"name":"Department of Immunology, Genetics and Pathology Uppsala University Uppsala Sweden"},{"name":"Department of Internal Medicine \u00d6rnsk\u00f6ldsvik Hospital \u00d6rnsk\u00f6ldsvik Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus R. K.","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Haematology Aalborg University Hospital Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University Aalborg Denmark"},{"name":"Center for Clinical Data Science Aalborg University Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Bentzen","sequence":"additional","affiliation":[{"name":"Department of Haematology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Riise","sequence":"additional","affiliation":[{"name":"Department of Oncology Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Haaber","sequence":"additional","affiliation":[{"name":"Department of Haematology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Pasanen","sequence":"additional","affiliation":[{"name":"Department of Oncology Helsinki University Comprehensive Cancer Centre Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Kuitunen","sequence":"additional","affiliation":[{"name":"Department of Oncology Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin F.","family":"Wader","sequence":"additional","affiliation":[{"name":"Department of Oncology St Olavs Hospital Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarec C.","family":"El\u2010Galaly","sequence":"additional","affiliation":[{"name":"Department of Haematology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Molecular Medicine Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hutchings","sequence":"additional","affiliation":[{"name":"Department of Haematology Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Glimelius","sequence":"additional","affiliation":[{"name":"Department of Immunology, Genetics and Pathology Uppsala University Uppsala Sweden"},{"name":"Department of Hematology and Oncology Akademiska Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Jerkeman","sequence":"additional","affiliation":[{"name":"Department of Oncology Skane University Hospital Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021013326"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-04-779736"},{"key":"e_1_2_13_4_1","article-title":"Frontline treatment of mantle cell lymphoma","volume":"18","author":"Ryan CE","year":"2024","journal-title":"Blood"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2022-157777"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00889-8"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306220"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33108-2"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-99-117956"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-01013-3"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00667-4"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.205229"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70200-0"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505237"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.5363"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(18)30018-8"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520250075037"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000928"},{"key":"e_1_2_13_19_1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.2340\/1651-226X.2024.40431","article-title":"The National Swedish Lymphoma Register\u2014a systematic validation of data quality","volume":"63","author":"Smedby KE","year":"2024","journal-title":"Acta Oncol"},{"key":"e_1_2_13_20_1","unstructured":"lymfomarsrapport2000\u20102019.pdf. 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