Introduction We conducted a multinational, multicenter retrospective registry study to better dene the treatment patterns and survival outcomes of newly diagnosed patients with mantle cell lymphoma (MCL) in the Asia-Pacic region. Methods Data were collected from newly diagnosed MCL patients between January 2008 and September 2019 from 27 hospitals in Asian countries, including China, Malaysia, Japan, Singapore, South Korea, Taiwan, and Thailand. The rst interim analysis with 191 patients was previously reported. An updated analysis of 381 patients was performed at the data cutoff date of June 20, 2023. Results The median age was 62 years (range, 26-90), and 282 patients were male (74.0%). The majority of the patients had stage 3 or 4 disease (n = 329, 87.1%). Based on the MIPI score, 20.7% (n = 139) were classied as high-risk, while 39.4% (n = 150) were classied as high-risk according to the IPI. The most frequently administered 1 st line regimen was R-CHOP or R-CHOP-like regimens (n = 177, 46.5%), followed by cytarabine-containing regimens (n = 113, 29.7%), including R-Hyper-CVAD (n = 78), and bendamustine-rituximab (n = 27, 6.3%). There was a signicant difference in the treatment pattern between young (age < 65, n = 210) versus elderly patients (age ≥ 65, n = 171). A higher proportion of elderly patients received R-CHOP or R-CHOPlike regimens (n = 98, 57.3%) while cytarabine-containing regimens were more frequently administered in young patients (n = 97, 46.2%). The treatment response to 1st line regimens was available in 349 patients. The overall response rate (ORR) and the complete response (CR) rate among these patients were 91.1% and 57.9%, respectively. The response rates (ORR/CR rate) for each regimen were as follows; 91.4%/49.1% for R-CHOP or R-CHOP-like regimens, 93.5%/67.3% for cytarabine-containing regimens, and 96.2%/76.9% for bendamustine-rituximab (BR). With a median follow-up duration of 82.6 months, the median progression-free survival (PFS) was 40.6 months, and the median overall survival (OS) was 86.8 months (Figure). The median PFS was 35.2 months for R-CHOP or R-CHOP-like regimens, 65.8 months for cytarabine-containing regimens, and 57.9 months for BR. The role of upfront ASCT was evaluated in pts who are < 65 years old and achieved at least partial response (PR) to 1 st line treatment (n = 181). No signicant differences were observed in baseline characteristics between patients who received upfront ASCT (n = 48) and those who did not (n = 133).