Objective This study aims to explore the survival advantages of different maintenance strategies for MCL.Methods Clinical data of 693 newly diagnosed MCL patients in multi-centers admitted from April 1999 to December 2019 were collected.309 cases received maintenance treatment.The characteristics of patients in different maintenance treatment groups were summarized and Kaplan-Meier survival and prognosis analysis were conducted.Results The overall 3-year and 5-year progression-free survival(PFS)rates were(73.5±2.9)％and(53.6±4.3)％,respectively.The 3-year and 5-year overall survival(OS)rates were(94.2±1.5)％and(82.7±3.2)％,respectively.The clinical features of different maintenance treatment groups were generally consistent.The 3-year PFS rates of rituximab maintenance,lenalidomide maintenance,BTK inhibitor maintenance and dual-drug maintenance were(70.4±4.1)％,(69.1±7.6)％,(86.9±5.0)％,and(80.4±5.1)％,respectively.Corresponding 3-year OS rates were(92.9±2.4)％,(97.3±2.7)％,(97.9±2.1)％,and(95.3±2.7)％,respectively.There were no significant difference in different groups(P=0.632,0.313).Survival analysis identified the MCL International Prognostic Index(MIPI)high-risk group and achieving complete remission before maintenance treatment as independent risk factors for PFS.The MIPI high-risk group,high-dose cytarabine application,treatment lines,and early disease progression(POD24)emerged as independent risk factors for OS.Conclusion Comparing the different maintenance strategies of MCL,the result showed that BTK inhibitors(BTKi)maintenance demonstrated preliminary advantages in survival.Meanwhile,high-risk group according to MIPI and incomplete remission before maintenance treatment were significant factors related to disease progression.
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