Contemporary real-world outcomes of mantle cell lymphoma in Colombia: Results from an expanded multicenter cohort.

Abstract

e19077 Background: Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin lymphoma with limited contemporary real-world data from Latin America. We report treatment patterns and outcomes in an expanded multicenter cohort from Colombia. Methods: We conducted a multicenter observational cohort study of adult patients with MCL treated at three tertiary referral centers in Colombia. The primary endpoint was overall survival (OS), estimated using the Kaplan–Meier method and compared with log-rank tests. Secondary endpoints included treatment patterns and response (overall response rate [ORR], complete remission [CR]). Results: A total of 152 patients were included. Median age at diagnosis was 64 years (IQR 56–72), and 73.7% were male. Advanced disease was common, with Ann Arbor stage IV in 83.0% and high-risk Mantle Cell Lymphoma International Prognostic Index (MIPI) in 51.3%. Classical morphology predominated (70.4%), followed by blastoid variants (11.3%). Comprehensive molecular profiling was not uniformly available, among patients with available data, complex karyotype was identified in 12.6%, SOX11 overexpression in 45.9% and 10.1% had p53 mutations. Cytarabine-based chemoimmunotherapy was the most common first-line approach, most frequently R-CHOP alternating with R-DHAP (45.3%). Among 65 patients eligible for ASCT, 53 (81.5%) underwent ASCT as first-line consolidation. ORR to first-line therapy was 81.5%, including complete remission in 58.9%. With a median follow-up of 51.8 months (reverse Kaplan–Meier; 95% CI 42.9–71.7), the estimated 5-year overall survival (OS) was 58.4% (95% CI 48.6–66.9%). Patients who underwent ASCT experienced significantly improved OS (log-rank p<0.001). In multivariable analysis, high Ki-67 (≥50%; HR 2.20; 95% CI 1.04–4.62; p=0.038) and ECOG performance status ≥2 (HR 2.93; 95% CI 1.33–6.47; p=0.008) were independently associated with inferior OS. Conclusions: In this large multicenter real-world cohort, patients with MCL frequently presented with advanced and high-risk disease. Despite incomplete molecular characterization, access to intensive frontline therapy, including high utilization of ASCT, achieved durable survival. Clinical risk factors, particularly Ki-67 and ECOG remained independently associated with overall survival, highlighting their prognostic value and practical relevance for risk stratification and treatment decision making in routine care within resource-limited settings. Baseline characteristics, treatment, and outcomes. Baseline characteristics Age (median, years) 64 (56–72) Male sex, n (%) 112 (73.7%) Ann Arbor stage IV, n (%) 122 (83.0%) High-risk M-IPI, n (%) 78 (51.3%) Classical morphology, n (%) 100 (70.4%) Cytarabine-based induction,n (%) 68 (45.3%) ASCT, n (%) 53/65 (81.5%) 5-year overall survival, % (95% CI) 58.4 (48.6–66.9) Overall response rate (ORR), % 81.5%