Assess population-level trends in mantle cell lymphoma (MCL)-specific mortality and survival from 2000 through 2023 across four treatment eras, with outcomes examined by age.
Approach:
Data and cohort: Retrospective SEER-17 analysis of 12,785 adults with first primary, pathologically confirmed MCL diagnosed from 2000–2023.
Treatment eras: Diagnoses were grouped into 2000–2006, 2007–2013, 2014–2019, and 2020–2023 eras, reflecting successive treatment changes.
Outcomes and analysis: Evaluated relative survival, overall survival, and cumulative incidence of MCL-specific and other-cause death. Competing-risk and regression models adjusted for demographic and disease characteristics; analyses included age-stratified comparisons.
Key Findings:
Three-year MCL-specific mortality declined from 34.2% in era 1 to 22.8% in era 4; three-year relative survival rose from 63.8% to 73.6%.
MCL-specific mortality decreased across eras in every age group, but remained highest among patients aged 85 years or older (52.1% in era 4).
The age-by-era interaction was significant (P = 0.009). In era 4 versus era 1, adjusted MCL-specific mortality associations were similar for patients aged 65 or younger and those older than 65 (SHR 0.53 in each group).
Adjusted overall-survival hazard ratios versus era 1 were 0.83, 0.69, and 0.69 for eras 2, 3, and 4, respectively.
Three-year cumulative incidence of death from other causes increased from 7.5% in era 1 to 8.9% in era 4.
Interpretation:
The authors report population-level reductions in MCL-specific mortality and improved survival across successive treatment eras, including among older patients. The observational analysis identifies associations with treatment era and does not establish that specific therapies caused the changes.
Limitations:
The study used retrospective population-based registry data.
Median follow-up was 3.3 years.
Conclusion:
Across SEER-17 diagnoses from 2000 through 2023, MCL-specific mortality declined across treatment eras and age groups, although mortality remained highest among patients aged 85 years or older.
