• Robert W Chen, Hongli Li, Steven H Bernstein, Samir Kahwash, Lisa M Rimsza, Stephen J Forman, Louis Constine, Thomas C Shea, Amanda F Cashen, Kristie A Blum, Timothy S Fenske, Paul M Barr, Tycel Phillips, Michael Leblanc, Richard I Fisher, Bruce D Cheson, Sonali M Smith, Malek Faham, Jennifer Wilkins, John P Leonard, Brad S Kahl, and Jonathan W Friedberg.
• City of Hope, Duarte, CA, USA.
• Br. J. Haematol. 2017 Mar 1; 176 (5): 759-769.

AbstractAggressive induction chemotherapy followed by autologous haematopoietic stem cell transplant (auto-HCT) is effective for younger patients with mantle cell lymphoma (MCL). However, the optimal induction regimen is widely debated. The Southwestern Oncology Group S1106 trial was designed to assess rituximab plus hyperCVAD/MTX/ARAC (hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone, alternating with high dose cytarabine and methotrexate) (RH) versus rituximab plus bendamustine (RB) in a randomized phase II trial to select a pre-transplant induction regimen for future development. Patients had previously untreated stage III, IV, or bulky stage II MCL and received either 4 cycles of RH or 6 cycles of RB, followed by auto-HCT. Fifty-three of a planned 160 patients were accrued; an unacceptably high mobilization failure rate (29%) on the RH arm prompted premature study closure. The estimated 2-year progression-free survival (PFS) was 81% vs. 82% and overall survival (OS) was 87% vs. 88% for RB and RH, respectively. RH is not an ideal platform for future multi-centre transplant trials in MCL. RB achieved a 2-year PFS of 81% and a 78% MRD negative rate. Premature closure of the study limited the sample size and the precision of PFS estimates and MRD rates. However, RB can achieve a deep remission and could be a platform for future trials in MCL.© 2016 John Wiley & Sons Ltd.

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