• Michinori Ogura, Kazuhito Yamamoto, Yasuo Morishima, Masashi Wakabayashi, Kensei Tobinai, Kiyoshi Ando, Naokuni Uike, Mitsutoshi Kurosawa, Hiroshi Gomyo, Masafumi Taniwaki, Kisato Nosaka, Norifumi Tsukamoto, Tatsu Shimoyama, Noriko Fukuhara, Yoshihiro Yakushijin, Kazunori Ohnishi, Kana Miyazaki, Kenichi Sawada, Nobuyuki Takayama, Ichiro Hanamura, Hirokazu Nagai, Hirofumi Kobayashi, Kensuke Usuki, Naoki Kobayashi, Kazuma Ohyashiki, Takahiko Utsumi, Kyoya Kumagai, Dai Maruyama, Ken Ohmachi, Yoshihiro Matsuno, Shigeo Nakamura, Tomomitsu Hotta, Kunihiro Tsukasaki, and Japan Clinical Oncology Group- Lymphoma Study Group (JCOG-LSG).
• Department of Hematology and Oncology, Kasugai Municipal Hospital, Kasugai, Japan.
• Cancer Sci. 2018 Sep 1; 109 (9): 2830-2840.

AbstractAlthough induction immunochemotherapy including high-dose cytarabine and rituximab followed by high-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) is recommended for younger patients (≤65 years old) with untreated mantle cell lymphoma (MCL), no standard induction and HDC regimen has been established. We conducted a phase II study of induction immunochemotherapy of R-High-CHOP/CHASER followed by HDC of LEED with ASCT in younger patients with untreated advanced MCL. Eligibility criteria included untreated MCL, stage II bulky to IV, and age 20-65 years. Patients received 1 cycle of R-High-CHOP followed by 3 cycles of CHASER every 3 weeks. Peripheral blood stem cells (PBSC) were harvested during CHASER. LEED with ASCT was delivered to patients who responded to R-High-CHOP/CHASER. Primary endpoint was 2-year progression-free survival (PFS). From June 2008 to June 2012, 45 patients (median age 59 years; range 38-65 years) were enrolled. PBSC were successfully harvested from 36 of 43 patients. Thirty-five patients completed ASCT. Two-year PFS was 77% (80% CI 68-84), which met the primary endpoint. Five-year PFS and overall survival were 52% (95% CI 34-68%) and 71% (95% CI 51-84%), respectively. Overall response and complete response rates after induction immunochemotherapy were 96% and 82%, respectively. The most common grade 4 toxicities were hematological. In younger patients with untreated MCL, R-High-CHOP/CHASER/LEED with ASCT showed high efficacy and acceptable toxicity, and it can now be considered a standard treatment option.© 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

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