Cytarabine-Based Regimens Linked to Longer Relapse-Free Survival in Mantle Cell Lymphoma
At ASCO 2025, researchers shared a retrospective cohort study comparing cytarabine-based and non-cytarabine-based induction regimens in mantle cell lymphoma (MCL). They found that cytarabine was associated with longer relapse-free survival (RFS), though overall survival (OS) differences did not reach statistical significance.
Researchers analyzed data from 223 patients diagnosed with MCL between 2010 and 2023 across Allegheny Health Network and Markey Cancer Center. Patients were grouped based on whether their induction therapy included cytarabine (Ara-c) or not (non-Ara-c). The study’s primary outcomes were overall survival and relapse-free survival.
Of the cohort, 72 patients (31%) received cytarabine-based regimens, and 151 patients (69%) received non-cytarabine-based regimens. The median patient age was 67.7 years, and 71% were male. The median follow-up was 5.6 years.
After propensity score matching, the Ara-c group had a median RFS of 4.8 years compared to 3.6 years in the non-Ara-c group, a statistically significant difference (P = 0.03). However, when the analysis was censored for autologous stem cell transplant (ASCT), the difference in RFS was no longer statistically significant—4.7 years for Ara-c versus 3.3 years for non-Ara-c (P = 0.16).
Median OS in the Ara-c group was 16.2 years compared to 12.95 years in the non-Ara-c group, but this difference did not reach statistical significance (P = 0.5), even after censoring for ASCT.
“In our cohort, cytarabine use in induction chemotherapy for MCL was associated with longer RFS and OS but it did not reach statistical significance,” the authors stated. They also noted that older and less fit patients were less likely to receive cytarabine.
The study underscores a potential benefit of cytarabine in prolonging relapse-free periods but calls for larger studies to confirm these findings and assess the impact on long-term survival outcomes.
Reference
Alnimer Y, Khan E, Ilyas R, et al. Assessing the role of cytarabine-based regimens in mantle cell lymphoma: a real world study. Presented at: ASCO 2025; May 30-June 3; Chicago, IL.
