A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma

Hoster, Eva; Dreyling, Martin; Klapper, Wolfram; Gisselbrecht, Christian; Hoof, A. van; Kluin-Nelemans, Hanneke C.; Pfreundschuh, Michael; Reiser, Marcel; Metzner, Bernd; Einsele, Hermann; Peter, Norma; Jung, Wolfram; Wörmann, Bernhard; Ludwig, Wolf‐Dieter; Dührsen, Ulrich; Eimermacher, Hartmut; Wandt, Hannes; Hasford, Joerg; Hiddemann, Wolfgang; Unterhalt, Michael

doi:10.1182/blood-2007-06-095331

Cited by 801 publications

(517 citation statements)

References 40 publications

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“…As observed in numerous previous studies, 23,[51][52][53][54][55][56] OS was found to be slightly lower in patients ⩾ 55 years without reaching any statistical significance in uni-and multivariate analysis. However, of greater clinical interest is that (1) the documented difference was so small that neither univariate nor multivariate analysis could reveal a significant impact of patient age on OS; and (2) stable plateaus for OS were reached for both subgroups, suggesting potential cure rates of 50% for younger and 42% for elderly patients (cf.…”

Section: Discussionsupporting

confidence: 59%

“…The median follow-up of surviving patients was 9.1 years (range 3.6-15.7). The Kaplan-Meier estimates for OS 1, 2, 5 and 10 years after HCT (95% confidence interval) were 67% (63-71), 60% (56-64), 53% (49-58) and 48% (44)(45)(46)(47)(48)(49)(50)(51)(52). The corresponding estimates for EFS were 63% (59-67), 53% (49-58), 47% (42-51) and 40% (36)(37)(38)(39)(40)(41)(42)(43)(44)(45).…”

Section: Conditioning Regimensmentioning

confidence: 91%

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Allogeneic hematopoietic cell transplantation as curative therapy for non-transformed follicular lymphomas

Heinzelmann

Bethge²,

Beelen

et al. 2016

Bone Marrow Transplant

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Allogeneic hematopoietic cell transplantation (HCT) offers the chance of cure for patients with non-transformed follicular lymphoma (FL), but is associated with the risk of non-relapse mortality (NRM). The aim of this study was to identify subgroups of FL patients who benefit from HCT. The European Society for Blood and Marrow Transplantation (EBMT) Minimum-Essential-A Data of 146 consecutive patients who received HCT for FL between 1998 and 2008 were extracted from the database of the German Registry 'DRST'. Diagnosis of FL was verified by contact with the reference pathologists. Estimated 1-, 2-and 5-year overall survivals (OS) were 67%, 60% and 53%, respectively. Day 100 NRM was 15%. Thirteen out of 33 patients (40%) with treatment-refractory disease (RD) at the time of transplantation survived long term. Univariate statistical analysis suggested limited chronic GvHD, donor age ⩽ 42 years and TBI-based conditioning in treatment refractory patients to correlate with favorable OS. Independent prognostic factors for OS were treatmentsensitive disease and limited chronic GvHD for the whole cohort, and additionally TBI-based conditioning for the treatment refractory subgroup. In contrast, patient age ⩾ 55 years had no impact on outcome. Thus, HCT for FL is associated with acceptable NRM, and offers a substantial chance of cure for patients with RD or advanced age. Donors ⩽ 42 years should be preferred if available.

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Section: Discussionsupporting

confidence: 59%

Section: Conditioning Regimensmentioning

confidence: 91%

Allogeneic hematopoietic cell transplantation as curative therapy for non-transformed follicular lymphomas

Heinzelmann

Bethge²,

Beelen

et al. 2016

Bone Marrow Transplant

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“…The MIPI has been validated and refined for previously untreated patients who received chemotherapy ± rituximab (Hoster et al , 2008, 2014). In our analysis, some but not all of the MIPI‐based factors were identified here as having a significant impact on PFS.…”

Section: Discussionmentioning

confidence: 99%

Prospective subgroup analyses of the randomized MCL‐002 (SPRINT) study: lenalidomide versus investigator's choice in relapsed or refractory mantle cell lymphoma

et al. 2017

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SummaryIn the mantle cell lymphoma (MCL)‐002 study, lenalidomide demonstrated significantly improved median progression‐free survival (PFS) compared with investigator's choice (IC) in patients with relapsed/refractory MCL. Here we present the long‐term follow‐up data and results of preplanned subgroup exploratory analyses from MCL‐002 to evaluate the potential impact of demographic factors, baseline clinical characteristics and prior therapies on PFS. In MCL‐002, patients with relapsed/refractory MCL were randomized 2:1 to receive lenalidomide (25 mg/day orally on days 1–21; 28‐day cycles) or single‐agent IC therapy (rituximab, gemcitabine, fludarabine, chlorambucil or cytarabine). The intent‐to‐treat population comprised 254 patients (lenalidomide, n = 170; IC, n = 84). Subgroup analyses of PFS favoured lenalidomide over IC across most characteristics, including risk factors, such as high MCL International Prognostic Index score, age ≥65 years, high lactate dehydrogenase (LDH), stage III/IV disease, high tumour burden, and refractoriness to last prior therapy. By multivariate Cox regression analysis, factors associated with significantly longer PFS (other than lenalidomide treatment) included normal LDH levels (P < 0·001), nonbulky disease (P = 0·045), <3 prior antilymphoma treatments (P = 0·005), and ≥6 months since last prior treatment (P = 0·032). Overall, lenalidomide improved PFS versus single‐agent IC therapy in patients with relapsed/refractory MCL, irrespective of many demographic factors, disease characteristics and prior treatment history.

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“…Typically, MCL has an aggressive clinical course that is resistant to therapy, with a mean survival of 3 years. 5 Recognition of MCL and its differentiation from other non-Hodgkin's lymphoma subtypes is important because of this poor prognosis and changing therapeutic regimens. …”

Section: Discussionmentioning

confidence: 99%

Mantle cell lymphoma: primary oral presentation

Ainscough

Power

Brown

2017

annals

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Mantle-cell lymphoma is an uncommon lymphoid malignancy of B-cells. It is often aggressive and prognosis is poor. A 69-year-old gentleman with a history of ischaemic heart disease was referred from primary care with a painless right floor of mouth swelling that had been present for 1 month. He otherwise completely asymptomatic. Incisional biopsy of the lesion was undertaken and marker studies demonstrated mantle cell lymphoma. Positron emission tomography-computed tomography and bone marrow biopsy showed widespread but low volume involvement. The patient was referred to the haematology multidisciplinary team for further assessment and treatment.

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A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma

Abstract: There is no generally established prognostic index for patients with mantle cell lymphoma (MCL),

Cited by 801 publications

References 40 publications

Allogeneic hematopoietic cell transplantation as curative therapy for non-transformed follicular lymphomas

Allogeneic hematopoietic cell transplantation as curative therapy for non-transformed follicular lymphomas

Prospective subgroup analyses of the randomized MCL‐002 (SPRINT) study: lenalidomide versus investigator's choice in relapsed or refractory mantle cell lymphoma

Mantle cell lymphoma: primary oral presentation

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