{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:20:04Z","timestamp":1767968404018,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T00:00:00Z","timestamp":1568851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T00:00:00Z","timestamp":1568851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The role of cytarabine-based induction and autologous stem cell transplantation (ASCT) in front-line treatment of younger patients with mantle cell lymphoma (MCL) is well established, however the utility of intensive approaches in older patients remains unclear. This retrospective study compared first line treatment outcomes in patients aged 60 years or more, treated at six tertiary centres between 2000\u20132015. 70 patients included had a median age of 69 (60\u201391) and most (94%) demonstrated advanced stage disease. Treatment regimens included: R-CHOP-like (n\u2009=\u200939), alternating R-CHOP\/R-DHAC (n\u2009=\u200910), R-HyperCVAD\/R-MA (n\u2009=\u20097), R-CHOP\/Cytarabine (Nordic Protocol) (n\u2009=\u200910) and other (n\u2009=\u20094). 16 patients underwent an ASCT. The median follow-up for surviving patients was 37 months. Compared to R-CHOP-like therapies, cytarabine-based regimens were associated with an improved overall response rate (ORR) of 70% vs 33% (p\u2009&lt;\u20090.001) and overall survival (OS) (HR 0.541, [0.292\u20131.001], p\u2009=\u20090.05). No difference in efficacy between different cytarabine-based regimens was detected, but R-HyperCVAD\/R-MA was associated with increased hospitalisation and transfusion requirements. Patients undergoing ASCT demonstrated an improved median OS (HR 0.108 [0.015\u20130.796], p\u2009=\u20090.029) but were significantly younger. These results reaffirm the use of cytarabine in MCL for selected patients aged over 60. Such regimens should be strongly considered for this population in frontline therapy.<\/jats:p>","DOI":"10.1038\/s41598-019-49776-9","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T10:04:13Z","timestamp":1568887453000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cytarabine-based induction immunochemotherapy in the front-line treatment of older patients with mantle cell lymphoma"],"prefix":"10.1038","volume":"9","author":[{"given":"Sumita","family":"Ratnasingam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Casan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jake","family":"Shortt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza","family":"Hawkes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gilbertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"McQuilten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Grigoriadis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kay Thwe","family":"Htun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swe Myo","family":"Htet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khai Li","family":"Chai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Quach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushrut","family":"Patil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0308-6458","authenticated-orcid":false,"given":"Stephen","family":"Opat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"49776_CR1","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1111\/bjh.14241","volume":"175","author":"CW Eskelund","year":"2016","unstructured":"Eskelund, C. W. et al. 15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2): prolonged remissions without survival plateau. Br. J. Haematol. 175, 410\u2013418 (2016).","journal-title":"Br. J. Haematol."},{"key":"49776_CR2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/j.1365-2141.2010.08228.x","volume":"27","author":"JE Romaguera","year":"2010","unstructured":"Romaguera, J. E. et al. Ten-year follow-up after intense chemoimmunotherapy with Rituximab-HyperCVAD alternating with Rituximab-high dose methotrexate\/cytarabine (R-MA) and without stem cell transplantation in patients with untreated aggressive mantle cell lymphoma. Br. J. Haematol. 27, 200\u2013208 (2010).","journal-title":"Br. J. Haematol."},{"key":"49776_CR3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1182\/blood-2011-09-370320","volume":"121","author":"R Delarue","year":"2013","unstructured":"Delarue, R. et al. CHOP and DHAP plus rituximab followed by autologous stem cell transplantation in mantle cell lymphoma: a phase 2 study from the Groupe d\u2019Etude des Lymphomes de l\u2019Adulte. Blood 121, 48\u201353 (2013).","journal-title":"Blood"},{"key":"49776_CR4","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1038\/bjc.2015.94","volume":"112","author":"A Smith","year":"2015","unstructured":"Smith, A. et al. Lymphoma incidence, survival and prevalence 2004\u20132014: sub-type analyses from the UK\u2019s Haematological Malignancy Research Network. Br. J. Cancer 112, 1575\u20131584 (2015).","journal-title":"Br. J. Cancer"},{"key":"49776_CR5","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/S0140-6736(16)00739-X","volume":"388","author":"O Hermine","year":"2016","unstructured":"Hermine, O. et al. Addition of high-dose cytarabine to immunochemotherapy before autologous stem-cell transplantation in patients aged 65 years or younger with mantle cell lymphoma (MCL Younger): a randomised, open-label, phase 3 trial of the European Mantle Cell Lymphoma Network. The Lancet 388, 565\u2013575 (2016).","journal-title":"The Lancet"},{"key":"49776_CR6","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1056\/NEJMoa1200920","volume":"367","author":"HC Kluin-Nelemans","year":"2012","unstructured":"Kluin-Nelemans, H. C. et al. Treatment of Older Patients with Mantle-Cell Lymphoma. N. Engl. J. Med. 367, 520\u2013531 (2012).","journal-title":"N. Engl. J. Med."},{"key":"49776_CR7","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1016\/S0140-6736(12)61763-2","volume":"381","author":"MJ Rummel","year":"2013","unstructured":"Rummel, M. J. et al. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet 381, 1203\u20131210 (2013).","journal-title":"Lancet"},{"key":"49776_CR8","doi-asserted-by":"publisher","first-page":"2944","DOI":"10.1182\/blood-2013-11-531327","volume":"123","author":"IW Flinn","year":"2014","unstructured":"Flinn, I. W. et al. Randomized trial of bendamustine-rituximab or R-CHOP\/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood 123, 2944\u20132952 (2014).","journal-title":"Blood"},{"key":"49776_CR9","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1200\/JCO.18.00605","volume":"37","author":"IW Flinn","year":"2019","unstructured":"Flinn, I. W. et al. 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However, their relationship with Roche bears no impact on the result or discussion reported in this paper. All other authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"13544"}}