Validation of POD24 as a robust early clinical indicator of poor survival in mantle cell lymphoma from 1280 patients on clinical trials, a LYSA study

In mantle cell lymphoma, early progression of disease has been associated with short overall survival. The impact of clinical, pathological, and treatment strategies on the risk of early relapse has not been assessed in a large cohort of patients. We performed a pooled analysis of patients recruited in France from six randomized first-line MCL trials. Among 1386 treated MCL patients, 1280 were evaluable for POD24 status: 299 (23.4%) with a POD24 event and 981 (76.6%) without. Patients with a POD24 event had a median OS of 9.3 months (95% CI 8.4-11.8) versus not reached (95% CI 97.8-NR) for those without POD24 events. The median post-relapse OS of patients with a late relapse was also significantly longer at 49.4 months (HR = 0.39; 95% CI 0.31-0.48; P < 0.001) as compared to POD24 patients. Baseline variables (age, performance status, B symptoms, LDH/ULN, leukocytes, blastoid variant, and Ki-67 > 30%) were significantly associated with the risk of POD24, independent of ASCT. Among responding patients at end-of-induction (n = 1105) who had received ASCT, anti-CD20 maintenance was associated with a decreased risk of POD24 (OR = 0.37; 95% CI 0.1-1.0). Using this large data set of patients in clinical trials, we confirm that POD24 status is strongly associated with subsequent OS in MCL. Rituximab maintenance provided significant protection against the risk of POD24, independent of ASCT. Progression within 2 years should be considered as a primary endpoint in future studies.

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Publication Details

Journal
Blood Cancer Journal
Published
2025-04-24
DOI
https://doi.org/10.1038/s41408-025-01241-9
Citations
3
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
4.41
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article

Validation of POD24 as a robust early clinical indicator of poor survival in mantle cell lymphoma from 1280 patients on clinical trials, a LYSA study

Lucie Obéric, Steven Le Gouill, Morgane Cheminant, Mats Jerkeman et al.
3 citations
Blood Cancer Journal
Lymphoma Diagnosis and Treatment
4.41
article

Validation of POD24 as a robust early clinical indicator of poor survival in mantle cell lymphoma from 1280 patients on clinical trials, a LYSA study

Lucie Obéric, Steven Le Gouill, Morgane Cheminant, Mats Jerkeman, Roch Houot, Vincent Ribrag, Catherine Thiéblemont, Eva Hoster, François Lemonnier, Hanneke C. Kluin‐Nelemans, Clémentine Sarkozy, Martin H. Dreyling, Franck Morschhauser, Loïc Chartier, Olivier Casasnovas, Gandhi Laurent Damaj, Olivier Hermine, Krimo Bouabdallah, Elizabeth Macintyre, Marie‐Hélène Delfau‐Larue, Rémy Gressin, Benoît Tessoulin, Barbara Burroni, Violaine Safar, Wolfram Klapper, Mary Callanan, Christian H. Geisler, Hervé Ghesquières, Michael Unterhalt, Christiane Pott
article en
3 citations

Abstract

In mantle cell lymphoma, early progression of disease has been associated with short overall survival. The impact of clinical, pathological, and treatment strategies on the risk of early relapse has not been assessed in a large cohort of patients. We performed a pooled analysis of patients recruited in France from six randomized first-line MCL trials. Among 1386 treated MCL patients, 1280 were evaluable for POD24 status: 299 (23.4%) with a POD24 event and 981 (76.6%) without. Patients with a POD24 event had a median OS of 9.3 months (95% CI 8.4-11.8) versus not reached (95% CI 97.8-NR) for those without POD24 events. The median post-relapse OS of patients with a late relapse was also significantly longer at 49.4 months (HR = 0.39; 95% CI 0.31-0.48; P < 0.001) as compared to POD24 patients. Baseline variables (age, performance status, B symptoms, LDH/ULN, leukocytes, blastoid variant, and Ki-67 > 30%) were significantly associated with the risk of POD24, independent of ASCT. Among responding patients at end-of-induction (n = 1105) who had received ASCT, anti-CD20 maintenance was associated with a decreased risk of POD24 (OR = 0.37; 95% CI 0.1-1.0). Using this large data set of patients in clinical trials, we confirm that POD24 status is strongly associated with subsequent OS in MCL. Rituximab maintenance provided significant protection against the risk of POD24, independent of ASCT. Progression within 2 years should be considered as a primary endpoint in future studies.

Blood Cancer JournalVol. 15(1)
Hôpital Necker-Enfants Malades (FR), University Medical Center Groningen (NL), Inserm (FR), Université de Bourgogne (FR), Lund University (SE), Université de Versailles Saint-Quentin-en-Yvelines (FR), Université Paris Cité (FR), Université de Lille (FR), Institut Gustave Roussy (FR), Copenhagen University Hospital (DK), Rigshospitalet (DK), Centre Hospitalier Universitaire de Bordeaux (FR), Centre Hospitalier Universitaire de Lille (FR), LMU Klinikum (DE), Centre Hospitalier Universitaire de Nantes (FR), Christian-Albrechts-Universität zu Kiel (DE), Sorbonne Paris Cité (FR), Hôpital Cochin (FR), Assistance Publique – Hôpitaux de Paris (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Zimmer Biomet (Germany) (DE), Normandie Université (FR), The Lymphoma Academic Research Organisation (FR), University Hospital Schleswig-Holstein (DE), Hôpital Lyon Sud (FR), CHU Dijon Bourgogne (FR), Groupe Hospitalier Cochin - Port-Royal, Hôtel-Dieu, Broca - La Collégiale (FR), Skåne University Hospital (SE), Centre de recherche Translationnelle en Médecine moléculaire (FR), Délégation Normandie (FR), Hôpital Saint-Louis (FR), Grenoble Institute of Neurosciences (FR), Centre Hospitalier Universitaire de Rennes (FR), Institut des Maladies Génétiques Imagine (FR), Institut Lavoisier de Versailles (FR), Microenvironment and B-cells: Immunopathology, Cell, Differentiation and Cancer (FR), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Université de Rennes (FR), Ludwig-Maximilians-Universität München (DE), Université Grenoble Alpes (FR), University of Lübeck (DE), Nantes Université (FR), Université de Caen Normandie (FR)
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Openalex Percentile: Top 6%
Lymphoma Diagnosis and Treatment
4.41
DOIOpen Access PDFOpenAlex
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