Avaliação de resposta e sobrevida dos pacientes portadores de linfoma de células do manto submetidos ao transplante autólogo de células tronco hematopoiéticas

Abstract

Background: Mantle cell lymphoma (MCL) is a rare and aggressive non-Hodgkin lymphoma subtype characterized by the t(11;14) (q13;q32) translocation, leading to cyclin D1 overexpression and cell cycle dysregulation. Despite advances in therapy, MCL remains incurable, typically displaying relapsing disease requiring successive treatment lines, posing significant challenges, especially in elderly patients. Methods: This retrospective, multicenter study evaluated the clinical, laboratory, and prognostic profiles of 40 patients with confirmed MCL who underwent autologous stem cell transplantation (ASCT) as consolidation therapy between 2004 and 2024 at two oncology centers in Minas Gerais, Brazil. Additional data from the Brazilian Mantle Cell Lymphoma Registry were incorporated. The study also investigated the impact of cytarabine use in the conditioning regimen on overall survival (OS) and progression-free survival (PFS). Results: Patients receiving cytarabine demonstrated significantly improved 3-year OS and PFS compared to those who did not (64% vs. 27% for PFS, p<0.01). Multivariate Cox regression analysis identified cytarabine use as a significant protective factor, reducing the risk of death by 89% (HR=0.11; 95% CI: 0.017–0.71; p=0.021) and the risk of progression by 84% (HR = 0.16; 95% CI: 0.02–0.93; p = 0.04). Although the Mantle Cell Lymphoma International Prognostic Index (MIPI) did not show a statistically significant association with survival, a trend toward better outcomes in low/intermediate-risk groups was observed. Conclusions: This study reinforces the therapeutic potential of cytarabine in conditioning regimens for MCL patients undergoing ASCT, aligning with international literature.