Simplified MIPI-B prognostic stratification method can predict the outcome well—retrospective analysis of clinical characteristics and management of newly-diagnosed mantle cell lymphoma patients from China

Abstract

Mantle cell lymphoma (MCL) is an invasive B-cell lymphoma with significant individual differences. Currently, MCL international prognostic index (MIPI) score and tumor cell proliferation index Ki-67 have been proved to be the most important prognostic factors. But the prognostic effect of these factors in Asian population is uncertain. This study aimed to analyze the disease characteristics and prognostic factors of Chinese MCL patients.A total of 83 cases of newly-diagnosed MCL patients diagnosed by the Department of Pathology of our hospital between January 1, 2011, and May 31, 2016, were enrolled. The disease characteristics, treatment effects, and outcomes of the patients were collected and analyzed.According to our analysis, MCL cases accounted for 6.2% of non-Hodgkin lymphoma (NHL) cases and mainly occurred in elderly males. But the proportion of patients at stage IV by Ann Arbor staging system and high-risk group by simplified-MIPI (s-MIPI) were significantly lower than that among European patients. Immunochemotherapy containing rituximab was significantly more effective than chemotherapy (overall response rate, [ORR]: 88.5% vs 65.2%, P = .021) and significantly prolonged patient survival (progression free survival [PFS]: 45.5 m vs 16.2 m, P = .001; overall survival [OS]: 58.3 m vs 22.8 m, P = .001). The multivariate analysis showed that the B symptoms, s-MIPI and administration of immunochemotherapy were independent prognostic factors that affected PFS and OS of the patients. s-MIPI and B symptom make up s-MIPI-B stratification method, by which patients in low-risk group of s-MIPI without B symptom were classified as low-risk, patients in high-risk group of s-MIPI and patients in low-risk group of s-MIPI with B symptom as high-risk, the rest as middle-risk. 3-year PFS of the 3 groups were 74.9%, 43.4% and 16.1%, respectively (P = .001). 3-year OS were 84.4%, 62.2%, 27.6% (P <.001).Chinese MCL was male predominance. We have a minor proportion of late-stage and high-risk patients compared to European patients. Immunochemotherapy was proved to significantly improve the prognosis of MCL patients. B symptoms, s-MIPI, and administration of rituximab independently influenced the outcome. s-MIPI-B prognostic stratification method may better predict the prognosis of Asian MCL patients. Still, further confirmation in larger populations is needed.

Mantle Hücreli Lenfoma Hastalarımızın Klinik ve Laboratuvar Özellikleri: Kesitsel Bir Çalışma

“…12 In consistency with the former results in literature, when our patients were classified according to their MIPI scores, lowrisk patient group had a significantly longer median survival (p=0.04) than that of highrisk patients and also the patients at moderaterisk had significantly longer PFS (p=0.025) compared to high-risk patients. 13 Ki-67 proliferation index is identified as one of the factors with highest prognostic value 14 , however, only 10 patient in our cohort had documented Ki-67 proliferation index and therefore, we were not able to conduct survival analysis for Ki-67 proliferation index.…”

A novel clinical immune‐related prognostic model predicts the overall survival of mantle cell lymphoma

“…analyzed 83 newly diagnosed MCL patients, and the results showed that B symptoms and the simplified MIPI were independent factors affecting OS and progression‐free survival in MCL patients. Based on the clinical data of this study, a prognostic model called s‐MIPI‐B was proposed 17 …”

“…Calibration curves for predicting MCL patients survival at 1-, 3-and 5-year for the IRPI (A1, A2, A3), MIPI (B1, B2, B3), and MIPI-c (C1, C2, C3) progression-free survival in MCL patients. Based on the clinical data of this study, a prognostic model called s-MIPI-B wasproposed 17. …”

Survival Outcomes of Patients with Mantle Cell Lymphoma: A Retrospective, 15-Year, Real-Life Study

“…However, 10–20% of patients are characterized by a leukemic, non-nodal (LNN) presentation, with more indolent clinical behavior and prolonged survival [ 4 , 5 , 6 ]. The MCL international prognostic index (MIPI), together with Ki-67 expression via immunohistochemistry, represents the most used prognostic tool used at diagnosis [ 7 , 8 ]. Moreover, the absence of SOX-11 overexpression is associated with LNN presentation [ 4 , 5 , 6 ].…”