Mantle Cell Lymphoma: A Single Centre Experience from a Tertiary Care Centre in North India

ABSTRACT

Introduction: Mantle cell lymphoma (MCL) is an aggressive lymphoma with an incidence of 2.4-6% among all non-Hodgkin's lymphoma. Though with the addition of rituximab to standard chemotherapy backbone with autologous stem cell transplant (ASCT) consolidation and novel small molecule inhibitors, the outcome of MCL has improved, however, not many patients undergo ASCT due to financial constraints. Aims & Objectives: To study the clinical profile of all patients of MCL over a period of 6 years and assess their outcome. Material(s) and Method(s) This study was a retrospective cohort study which included all patients diagnosed with mantle cell lymphoma, between January 2016 to January 2022, conducted in the Department of Haematology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, India. A total of 53 cases were included in the study. SPSS-23 was used for the data analysis. Result(s) The median age was 59 years (ranging from 39-81 years), with a male to female ratio of 5.31. The ECOG performance status was of 0-2 was seen in 85.2%. The median haemoglobin, leukocyte count and platelet count at presentation was 10.6 g/dL, 7400/mm3 and 1,52,000/mm3 respectively. Of the 53 patients, 48% presenting with B symptoms. The median Lactate dehydrogenase levels were 521 (ranging from 220-1230). 72% patients presented with stage IV disease and MIPI score was high, intermediate and low risk in 43.4%, 32.1% and 24.5% low risk. 48% patients received RCHOP/RDHAP regimen, 36% received RCHOP and 16% received R-Benda. 5 patients underwent ASCT. 13 patients relapsed, 1 was refractory and 1 died post-transplant due to Covid sepsis. The third patient, who had relapsed, received R Benda, was found to have multiple myeloma 1 year after therapy, and succumbed to sepsis. 63% were put on Rituximab maintenance. Conclusion(s) MCL is a rare, aggressive B cell lymphoma with a lesser incidence in Indian population compared to the world. While aggressive chemotherapy with monoclonal antibody has improved the response rate of patients with nodal MCL, wait and watch strategy remains the backbone of management of leukaemic NNMCL.