{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:08:19Z","timestamp":1788433699509,"version":"build-2803163510"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2024,2,10]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> The outcome of older patients with mantle cell lymphoma (MCL) has improved by the introduction of immunochemotherapy, followed by rituximab (R)-maintenance. Assessment of minimal residual disease (MRD) represents a promising tool for individualized treatment decisions and was a prospectively planned part of the European MCL Elderly trial. We investigated how MRD status influenced the efficacy of R-maintenance and how MRD can enable tailored consolidation strategies. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> Previously untreated patients with MCL age 60 years or older have been randomly assigned to R versus interferon-alpha maintenance after response to rituximab, fludarabine, cyclophosphamide (R-FC) versus rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP). MRD monitoring was performed by real-time quantitative polymerase chain reaction (qPCR) following EuroMRD guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> A qPCR assay with a median sensitivity of 1 \u00d7 10<jats:sup>\u22125<\/jats:sup> could be generated in 80% of 288 patients in an international, multicenter, multilaboratory setting. More extensive tumor dissemination facilitated the identification of a molecular marker. The efficacy of R-maintenance in clinical remission was confirmed for MRD-negative patients at the end of induction in terms of progression-free survival (PFS; hazard ratio [HR], 0.38 [95% CI, 0.21 to 0.63]) and overall survival (OS; HR, 0.37 [95% CI, 0.20 to 0.68]), particularly in R-CHOP\u2013treated patients (PFS-HR, 0.23 [95% CI, 0.10 to 0.52]; OS-HR, 0.19 [95% CI, 0.07 to 0.52]). R-maintenance appeared less effective in MRD-positive patients (PFS-HR, 0.51 [95% CI, 0.26 to 1.02]) overall and after R-CHOP induction (PFS-HR, 0.59 [95% CI, 0.28 to 1.26]). R-FC achieved more frequent and faster MRD clearance compared with R-CHOP. MRD positivity in clinical remission after induction was associated with a short median time to clinical progression of approximately 1-1.7 years. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> The results confirm the strong efficacy of R-maintenance in patients who are MRD-negative after induction. Treatment de-escalation for MRD-negative patients is discouraged by our results. More effective consolidation strategies should be explored in MRD-positive patients to improve their long-term prognosis. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.23.00899","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T21:00:17Z","timestamp":1700686817000},"page":"538-549","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":20,"title":["Predictive Value of Minimal Residual Disease for Efficacy of Rituximab Maintenance in Mantle Cell Lymphoma: Results From the European Mantle Cell Lymphoma Elderly Trial"],"prefix":"10.1200","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct00209209","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0749-1389","authenticated-orcid":false,"given":"Eva","family":"Hoster","sequence":"first","affiliation":[{"name":"Institute for Medical Informatics, Biometry, and Epidemiology (IBE), LMU Munich, Munich, 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Informatics, Biometry, and Epidemiology (IBE), LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Stilgenbauer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University of Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Vehling-Kaiser","sequence":"additional","affiliation":[{"name":"VK&K Studien GbR, Landshut, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-8666","authenticated-orcid":false,"given":"Gilles","family":"Salles","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Universit\u00e9 Claude Bernard, Centre Hospitalier Lyon-Sud, Pierre B\u00e9nite, France"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Feugier","sequence":"additional","affiliation":[{"name":"Department of Hematology and INSERM 1256, University of Lorraine, Vandoeuvre les Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"H\u00fcbel","sequence":"additional","affiliation":[{"name":"Klinik I f\u00fcr Innere Medizin, Universit\u00e4t zu K\u00f6ln, K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Ribrag","sequence":"additional","affiliation":[{"name":"Institut Gustave Roussy, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-9427","authenticated-orcid":false,"given":"Johanna C.","family":"Kluin-Nelemans","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0358-5249","authenticated-orcid":false,"given":"Martin","family":"Dreyling","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9260-8340","authenticated-orcid":false,"given":"Christiane","family":"Pott","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Hospital Schleswig-Holstein Campus Kiel\/Christian-Albrechts University Kiel, 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