Survival Trends In Mantle Cell Lymphoma In The United States Over 16 Years, 1992-2007

e18530 Background: Mantle cell lymphoma is a subtype of Non-Hodgkin’s lymphoma and constitutes six percent of cases. Prognosis is poor with median overall survival approximately 3-5 years. Several new treatment protocols have emerged over the last decade. The purpose of this study is to determine if newer protocols and regimens have translated into an overall survival benefit in the United States. Methods: Retrospective cohort analysis was done using the Surveillance, Epidemiology, and End-Results (SEER) database of the national cancer institute. A total of 5367 cases of mantle cell lymphoma were identified from 1992-2007 using the SEER database. Cases were split into three different cohorts. Group 1 included all cases of mantle cell lymphoma from 1992- 1999, Group 2 included cases from 2000-2003 and Group 3 was from 2004-2007. Overall Survival was analyzed using a Cox proportional hazards model to adjust for age, gender and disease stage and summarized using ANOVA. Results: The proportion of advanced cases compared to localized has increased over the years (Fisher’s exact test p= 0.0012). In a survival model, increased age (4.6%, p< 0.001) and male sex (19.2 %, p< 0.001) were both associated with a higher mortality. Compared to the cohort from 1992-1999 (group1), mortality was reduced in 2000-2003(group 2) by 9.5% (p=0.03) and in 2004-2007 (group 3) by 14.6% (p=0.0036). Patients with localized disease had a 38.8% better survival than those with advanced disease (p < 0.001), but there was no difference between the groups in survival in patients with localized disease. For patients with advanced disease, there is a 14.1% reduction in mortality in group 2 (p=0.0064) compared to group 1. Mortality in group 3 was 22.8 % lower than group 1 (p<0.001), and 8.7% lower than group 2. Conclusions: The survival for patients with mantle cell lymphoma with advanced stage has improved in the United States over the last sixteen years. However, the overall survival remains unchanged. This is most likely due to a significant increase in the proportion of patients with poor prognostic features- advanced age, male sex and advanced stage of disease. In a survival model predicted by disease stage,age, sex and year group, a significantly better survival was noted in women.