Why did we do this study?
Mantle cell lymphoma (MCL) is rare and tends to be diagnosed in people around 70 years of age. It is more common in men than women. Most (though not all) people with MCL will need chemotherapy. Although there are guidelines on the first chemotherapy to be given, there is no advice about which to offer next, if the cancer progresses. Findings from clinical trials suggested that new treatments for MCL have improved survival. As such studies tend to include younger and fitter patients, we wanted to know if these positive results would be the same in older and less fitter people, which we examined within YHHN.
What did we do?
We collected disease-specific information from the NHS medical records of all patients with MCL, in each of the 14 hospitals in the YHHN area. Treatment data from patients diagnosed 2004 to 2015 were analysed. We then monitored the same group until 2017, to check how they responded to treatment.
What did we find?
We found that treatment had changed a lot over time, as new chemotherapies were introduced. For example, chlorambucil and FC (fludarabine and cyclophosphamide) chemotherapy (with or without rituximab) were often given in the past, with high dose cytarabine, bendamustine or ibrutinib replacing this. Improved survival was seen in patients treated more recently across YHHN, suggesting that the newer agents improved outcomes for all people. Findings from this audit were published in a medical journal and submitted to NICE (National Institute for Health and Care Excellence) to get approval for ibrutinib to be used for patients with relapsed MCL across the NHS.