Significant variations in first-line mantle cell lymphoma care-an Australasian Lymphoma and Related Diseases Registry...

Mantle cell lymphoma (MCL) is a rare malignancy with evolving treatment paradigms. We analyzed 323 MCL patients prospectively recruited to the Australasian Binational Lymphoma Registry between January 2016 and February 2025. Median age was 68 years (range 39-95) and 60% (n = 155) were aged ≥65. Sixteen different first-line regimens were documented. Of young patients <65 years, 81% (n = 85/105) received cytarabine-containing chemoimmunotherapy compared to 23% in those over 65 years. Only 48% of older patients received bendamustine-rituximab based regimens. Autologous stem cell transplant (ASCT) was performed in 44% of patients (aged 43-70 years) and 13% received maintenance rituximab (MR). Three-year progression-free survival (PFS) and overall survival (OS) were 54% (95% confidence interval (CI) 45-62) and 68% (59-74), respectively. In those ≤70 years, ASCT was not associated with PFS or OS. This registry analysis highlights considerable variability in upfront MCL therapy with low ASCT and MR use, providing an important benchmark for emerging standards of care in Australia.