OBJECTIVES: Describing the profile and management of patients with Mantle Cell Lymphoma (MCL) in Spain.

METHODS: Real-world data were drawn from the Adelphi MCL Disease-Specific Programme™, a cross-sectional survey conducted between March-October 2022 among hematologists across Spain. Physicians extracted medical records for MCL patients´ demographics, clinical profiles and treatment patterns. Patients who were participating in clinical trials were excluded. Thirty physicians completed medical record forms for 4 consecutive patients with a 1:3 ratio of first-line to relapsed/refractory (R/R) patients. Descriptive analyses were reported.

RESULTS: Data from 119 patients were collected, with 71% male, median age 70 years (IQR 61, 79) and median time since diagnosis of 34 months (IQR 9.8, 54.7). At the time of initial diagnosis, most of the patients presented stage IV (55%) and ECOG 1 (38%), with median of 4 (IQR 3, 6) nodal locations. The most frequent MCL histologic subtype was classic (82%), followed by blastoid/pleomorphic (10%). Bulky disease (diameter >5cm) was present in 11%. In their most recent test, 96% of patients had high Ki67 (77 tested) and 26% had high TP53 (61 tested). At data capture, 30 patients (25%) were in first line (1L) of treatment, 42 (35%) in the second (2L) and 47 (39%) in the third or successive lines. Moreover, 42 patients were considered eligible for stem cell transplantation (SCT). In 1L, 15% had received autologous and 0% allogeneic SCT. The most frequent treatments were R-CHOP (± other chemoimmunotherapy) in 1L (38%), ibrutinib in 2L (66%) and bendamustine with rituximab in 3L (21%). Overall response rates (ORR) were 79%, 57% and 47% in 1L, 2L and 3L respectively.

CONCLUSIONS: A large number of patients presented clinical characteristics of poor prognosis at initial diagnosis. The progressive decrease in ORR raises the need of identifying novel therapeutic targets in the R/R setting.