The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT)

Geisler, Christian H.; Kolstad, Arne; Laurell, Anna; Räty, Riikka; Jerkeman, Mats; Eriksson, Mikael; Nordström, Marie; Kimby, Eva; Boesen, Anne Marie; Nilsson‐Ehle, Herman; Kuittinen, Outi; Lauritzsen, Grete F.; Ralfkiær, Elisabeth; Ehinger, Mats; Sundström, Christer; Delabie, Jan; Karjalainen-Lindsberg, Marja Liisa; Brown, Peter N.; Elonen, Erkki

doi:10.1182/blood-2009-08-236570

Cited by 164 publications

(98 citation statements)

References 23 publications

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“…A simplified modification of the MIPI has also been developed which has high concordance to the original MIPI, but slightly less discriminatory power [23] (Table I). The addition of the Ki-67 proliferation index also provides some additional discriminatory power [23].…”

Section: Risk Stratificationmentioning

confidence: 99%

“…Patients with 0-3 points are low risk, patients with 4-5 points are intermediate risk, and patients with 6-11 points are high risk. These risk categories correspond to the categories of the original MIPI [23].…”

Section: Risk Stratificationmentioning

confidence: 99%

“…The addition of the Ki-67 proliferation index also provides some additional discriminatory power [23].…”

Section: Risk Stratificationmentioning

confidence: 99%

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Mantle cell lymphoma: 2015 update on diagnosis, risk‐stratification, and clinical management

Vose

2015

American J Hematol

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Disease Overview: Mantle cell lymphoma (MCL) is a non‐Hodgkin lymphoma characterized by involvement of the lymph nodes, spleen, blood and bone marrow with a short remission duration to standard therapies and a median overall survival (OS) of 4‐5 years.Diagnosis: Diagnosis is based on lymph node, bone marrow, or tissue morphology of centrocytic lymphocytes, small cell type, or blastoid variant cells. A chromosomal translocation t (11:14) is the molecular hallmark of MCL, resulting in the overexpression of cyclin D1. Cyclin D1 is detected by immunohistochemistry in 98% of cases. The absence of SOX‐11 or a low Ki‐67 may correlate with a more indolent form of MCL. The differential diagnosis of MCL includes small lymphocytic lymphoma, marginal zone lymphoma, and follicular lymphoma.Risk Stratification: The MCL International Prognostic Index (MIPI) is the prognostic model most often used and incorporates ECOG performance status, age, leukocyte count, and lactic dehydrogenase. A modification of the MIPI also adds the Ki‐67 proliferative index if available. The median OS for the low‐risk group was not reached (5‐year OS of 60%). The median OS for the intermediate risk group was 51 months and 29 months for the high risk group.Risk‐Adapted Therapy: For selected indolent, low MIPI MCL patients, initial observation may be appropriate therapy. For younger patients with intermediate or high risk MIPI MCL, aggressive therapy with a cytotoxic regimen ± autologous stem cell transplantation should be considered. For older MCL patients with intermediate or high risk MIPI, combination chemotherapy with R‐CHOP, R‐Bendamustine, or a clinical trial should be considered. In addition, rituximab maintenance therapy may prolong the progression‐free survival. At the time of relapse, agents directed at activated pathways in MCL cells such as bortezomib (NFkB inhibitor), lenalidamide (anti‐angiogenesis) and Ibruitinib (Bruton's Tyrosine Kinase [BTK] inhibitor) have demonstrated excellent clinical activity in MCL patients. Autologous or allogeneic stem cell transplantation can also be considered in young patients. Clinical trials with novel agents are always a consideration for MCL patients. Am. J. Hematol. 90:740–745, 2015. © 2015 Wiley Periodicals, Inc.

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Section: Risk Stratificationmentioning

confidence: 99%

Section: Risk Stratificationmentioning

confidence: 99%

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Mantle cell lymphoma: 2015 update on diagnosis, risk‐stratification, and clinical management

Vose

2015

American J Hematol

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“…Compared to the results of the MCL1 trial using high--dose CHOP x 4 followed by BEAM and ASCT [1] the outcome was dramatically improved by the addition of rituximab and high--dose AraC, to a total of 6 induction cycles (R--maxi--CHOP alternating with R--AraC [2]. However, analysed according to the Mantle Cell Lymphoma International Prognostic Index (MIPI) [5] the outcome among high--risk patients was significantly inferior compared with low and intermediate risk [3], both in terms of response, response duration and of survival. Furthermore we identified high Ki--67 expression as the single most important prognostic factor [6].…”

Section: To the Editormentioning

confidence: 99%

High dose cytarabine with rituximab is not enough in first-line treatment of mantle cell lymphoma with high proliferation: early closure of the Nordic Lymphoma Group Mantle Cell Lymphoma 5 trial

Laurell

Kolstad

Räty

et al. 2013

Leukemia & Lymphoma

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“…The cell proliferative index (Ki-67) has also been shown to be of additional prognostic significance. 5,6 No consensus exists regarding frontline therapy for MCL, although standards are emerging. The management of relapsed MCL is an area of intense study.…”

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confidence: 99%

Emerging Therapy for the Treatment of Mantle Cell Lymphoma

Rajguru

Kahl

2014

J Natl Compr Canc Netw

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Mantle cell lymphoma (MCL) is a heterogenous disease with historically relative poor outcomes. However, new treatment strategies seem to be improving the prognosis for patients. Although no universally accepted standard of care exists, options for patients with newly diagnosed MCL include intensive and nonintensive strategies. Generally, intensive strategies produce more durable remissions and are selected for younger patients, whereas nonintensive strategies are most appropriate for older patients or patients with comorbidities. However, new options are closing the treatment gap between intensive and nonintensive strategies. Treatment options are also increasing for patients with relapsed/refractory MCL and include agents targeting the microenvironment and the B-cell receptor signaling pathway. (J Natl Compr Canc Netw 2014;12:1311-1318

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The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT)

Cited by 164 publications

References 23 publications

Mantle cell lymphoma: 2015 update on diagnosis, risk‐stratification, and clinical management

Mantle cell lymphoma: 2015 update on diagnosis, risk‐stratification, and clinical management

High dose cytarabine with rituximab is not enough in first-line treatment of mantle cell lymphoma with high proliferation: early closure of the Nordic Lymphoma Group Mantle Cell Lymphoma 5 trial

Emerging Therapy for the Treatment of Mantle Cell Lymphoma

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