Originally published as JCO Early Release 10.1200/JCO.2009.24.0176 on October 5 2009

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Reply to H.E. Eve et al

Center for Lymphoma and Myeloma, Weill Cornell Cancer Center, Weill Cornell Medical College and NewYork-Presbyterian Hospital, New York, NY

We read with interest the letter submitted by Eve et al¹ in response to our recent report² in Journal of Clinical Oncology. Their observations are consistent with our experience that up to one third of patients diagnosed with mantle-cell lymphoma may defer treatment (in the absence of symptoms or other indications for therapy) with no apparent detriment to their long-term outcome.

The thoughtful comments made by Eve et al¹ highlight the role of clinical assessment by the hematologist/oncologist in determining the potential need for therapy, with a particular eye toward preservation of quality of life. We strongly agree with their point that biologic and clinical markers need to be additionally developed to predict outcome for patient subsets and direct specific management of such groups on the basis of prospective comparative data. Clearly, cooperative clinical studies of such tools should be a priority for those involved in the care of such patients. We await data that can be used to best define therapy selection. In the meantime, we remain convinced that the clinical judgment of the treating physician, developed through careful monitoring over a period of observation when feasible, is a valuable tool in making management decisions. This information, in conjunction with collaborative discussions with patients regarding their individual goals for therapy, can contribute vital information to optimizing outcome in mantle-cell lymphoma.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The author(s) indicated no potential conflicts of interest.

REFERENCES

1. Eve HE, Furtado MV, Hamon MD, et al: Time to treatment does not influence overall survival in newly diagnosed mantle-cell lymphoma. J Clin Oncol 27:e189–e190, 2009.[Free Full Text]

2. Martin P, Chadburn A, Christos P, et al: Outcome of deferred initial therapy in mantle-cell lymphoma. J Clin Oncol 27:1209–1213, 2009.[Abstract/Free Full Text]

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