Survival Gains and Reduced Age-Related Disparities in Mantle Cell Lymphoma Over Successive Treatment Eras
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By
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Malak Munir
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John L. Vaughn
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Sravani Rimmalapudi
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Narendranath Epperla
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October 13, 2026
Clinical Report: Survival Gains and Reduced Age-Related Disparities in MCL
Overview
In a SEER-17 cohort of 12,785 adults diagnosed with mantle cell lymphoma (MCL) from 2000 through 2023, successive treatment eras were associated with lower 3-year MCL-specific mortality and higher relative survival. Mortality declined in both age groups, although patients older than 65 years continued to have higher MCL-specific mortality than younger patients.
Background
MCL is an aggressive B-cell non-Hodgkin lymphoma that occurs primarily in older adults and has a pronounced male predominance. Treatment has evolved through incorporation of rituximab, intensified immunochemotherapy, autologous stem cell transplantation for selected patients, Bruton tyrosine kinase inhibitors, and CAR-T therapies for relapsed or refractory disease. The source notes that population-level survival trends across treatment eras, particularly among older patients, have been inadequately characterized. This study used SEER-17 data to examine survival and cause-specific mortality from 2000 through 2023, with outcomes assessed by age.
Data Highlights
| Measure | Result |
|---|---|
| Study cohort | 12,785 adults diagnosed from 2000–2023; mean age 67.2 years; median follow-up 3.3 years |
| Patients by treatment era | Era 1 (2000–2006): 2,816 (22.0%); era 2 (2007–2013): 3,657 (28.6%); era 3 (2014–2019): 3,742 (29.3%); era 4 (2020–2023): 2,570 (20.1%) |
| Three-year MCL-specific mortality by era | 34.2% in era 1; 29.9% in era 2; 24.7% in era 3; 22.8% in era 4 (Gray’s P < 0.001) |
| Three-year relative survival by era | 63.8% in era 1; 68.7% in era 2; 71.9% in era 3; 73.6% in era 4 |
| Three-year mortality from other causes | Increased from 7.5% in era 1 to 8.9% in era 4 (Gray’s P < 0.001) |
| Three-year MCL-specific mortality by age | 19.7% among patients ≤65 years versus 35.4% among patients >65 years (Gray’s P < 0.001) |
| Change in MCL-specific mortality, era 1 to era 4 | Patients ≤65 years: 24.2% to 14.8% (38.8% relative reduction); patients >65 years: 42.5% to 28.5% |
Key Findings
- The cohort included 12,785 adults with first primary, pathologically confirmed MCL; 56.0% were older than 65 years.
- Three-year MCL-specific mortality decreased from 34.2% in 2000–2006 to 22.8% in 2020–2023, an absolute reduction of 11.4 percentage points; the era comparison was significant (Gray’s P < 0.001).
- Three-year relative survival rose sequentially from 63.8% in era 1 to 68.7%, 71.9%, and 73.6% in eras 2, 3, and 4, respectively.
- Across eras, three-year MCL-specific mortality was lower among patients aged ≤65 years than among those aged >65 years (19.7% vs 35.4%; Gray’s P < 0.001).
- From era 1 to era 4, MCL-specific mortality fell from 24.2% to 14.8% among patients aged ≤65 years and from 42.5% to 28.5% among patients aged >65 years.
- Three-year mortality from causes other than MCL increased modestly, from 7.5% in era 1 to 8.9% in era 4 (Gray’s P < 0.001).
Clinical Implications
The population-level results document lower MCL-specific mortality and higher relative survival across the treatment eras studied, including among patients older than 65 years. However, MCL-specific mortality remained higher in the older age group, and the study also reported a modest increase in mortality from other causes.
Conclusion
In this SEER-17 analysis, successive treatment eras were associated with improved survival measures and reduced MCL-specific mortality across age groups. The age-related difference in MCL-specific mortality persisted through the most recent era examined.
Related Resources & Content
- Source article, supplied text -- Survival Gains and Reduced Age-Related Disparities in Mantle Cell Lymphoma Over Successive Treatment Eras
- Gerson JN, Handorf E, Villa D, et al., Journal of Clinical Oncology, 2019 -- Survival Outcomes of Younger Patients With Mantle Cell Lymphoma Treated in the Rituximab Era
- ASCO Annual Meeting, 2020 -- Older patients with mantle cell lymphoma (MCL): Practice patterns and predictors of survival in the rituximab era
- ASCO Publications — Survival Outcomes of Younger Patients With Mantle Cell Lymphoma Treated in the Rituximab Era
- ASCO Publications — Survival trends in mantle cell lymphoma in the United States over 16 years, 1992-2007.
- Mantle Cell Lymphoma Treatment (PDQ®) - NCI
- TRIANGLE trial: Ibrutinib combined with immunochemotherapy with or without autologous stem-cell transplantation in previously untreated mantle cell lymphoma
- FDA grants accelerated approval to pirtobrutinib for relapsed or refractory mantle cell lymphoma
- Mantle Cell Lymphoma Treatment (PDQ®) - NCI
- Ibrutinib combined with immunochemotherapy with or without autologous stem-cell transplantation versus immunochemotherapy and autologous stem-cell transplantation in previously untreated patients with mantle cell lymphoma (TRIANGLE): a three-arm, randomised, open-label, phase 3 superiority trial of the European Mantle Cell Lymphoma Network - ScienceDirect
- FDA grants accelerated approval to pirtobrutinib for relapsed or refractory mantle cell lymphoma | FDA
Based on findings from:
Improving survival and narrowing age disparities in mantle cell lymphoma across therapeutic eras
Malak Munir, John L. Vaughn, Sravani Rimmalapudi, Narendranath Epperla. Blood Cancer Journal, 2026.
https://www.nature.com/articles/s41408-026-01648-y
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
