TY - JOUR
T1 - Evaluation of clinical parameters and biomarkers in older, untreated mantle cell lymphoma patients receiving bendamustine–rituximab
AU - Ramsower, Colleen A.
AU - Rosenthal, Allison
AU - Robetorye, Ryan S.
AU - Mwangi, Raphael
AU - Maurer, Matthew
AU - Villa, Diego
AU - McDonnell, Tim
AU - Feldman, Andrew
AU - Cohen, Jonathon B
AU - Habermann, Thomas
AU - Campo, Elias
AU - Clot, Guillem
AU - Bühler, Marco M
AU - Kulis, Marta
AU - Martin-Subero, Jose Ignacio
AU - Giné, Eva
AU - Cook, James R.
AU - Hill, Brian
AU - Raess, Philipp W.
AU - Beiske, Klaus H.
AU - Reichart, Alexander
AU - Hartmann, Sylvia
AU - Holte, Harald
AU - Scott, David
AU - Rimsza, Lisa
N1 - Publisher Copyright:
© 2023 British Society for Haematology and John Wiley & Sons Ltd.
PY - 2024/1
Y1 - 2024/1
N2 - Mantle cell lymphoma (MCL) is clinically and biologically heterogeneous. While various prognostic features have been proposed, none currently impact therapy selection, particularly in older patients, for whom treatment is primarily dictated by age and comorbidities. Herein, we undertook a comprehensive comparison of clinicopathological features in a cohort of patients 60 years and older, uniformly treated with bendamustine and rituximab, with a median survival of >8 years. The strongest prognostic indicators in this cohort were a high-risk call by a simplified MCL international prognostic index (s-MIPI) (HR: 3.32, 95% CI: 1.65–6.68 compared to low risk), a high-risk call by MCL35 (HR: 10.34, 95% CI: 2.37–45.20 compared to low risk) and blastoid cytology (HR: 4.21, 95% CR: 1.92–9.22 compared to classic). Patients called high risk by both the s-MIPI and MCL35 had the most dismal prognosis (HR: 11.58, 95% CI: 4.10–32.72), while those with high risk by either had a moderate but clinically relevant prognosis (HR: 2.95, 95% CI: 1.49–5.82). A robust assay to assess proliferation, such as MCL35, along with stringent guidelines for cytological evaluation of MCL, in combination with MIPI, may be a strong path to risk-stratify older MCL patients in future clinical trials.
AB - Mantle cell lymphoma (MCL) is clinically and biologically heterogeneous. While various prognostic features have been proposed, none currently impact therapy selection, particularly in older patients, for whom treatment is primarily dictated by age and comorbidities. Herein, we undertook a comprehensive comparison of clinicopathological features in a cohort of patients 60 years and older, uniformly treated with bendamustine and rituximab, with a median survival of >8 years. The strongest prognostic indicators in this cohort were a high-risk call by a simplified MCL international prognostic index (s-MIPI) (HR: 3.32, 95% CI: 1.65–6.68 compared to low risk), a high-risk call by MCL35 (HR: 10.34, 95% CI: 2.37–45.20 compared to low risk) and blastoid cytology (HR: 4.21, 95% CR: 1.92–9.22 compared to classic). Patients called high risk by both the s-MIPI and MCL35 had the most dismal prognosis (HR: 11.58, 95% CI: 4.10–32.72), while those with high risk by either had a moderate but clinically relevant prognosis (HR: 2.95, 95% CI: 1.49–5.82). A robust assay to assess proliferation, such as MCL35, along with stringent guidelines for cytological evaluation of MCL, in combination with MIPI, may be a strong path to risk-stratify older MCL patients in future clinical trials.
KW - MCL35
KW - MIPI
KW - mantle cell lymphoma
KW - prognosis
KW - proliferation
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U2 - 10.1111/bjh.19153
DO - 10.1111/bjh.19153
M3 - Article
C2 - 37881141
AN - SCOPUS:85174827442
SN - 0007-1048
VL - 204
SP - 160
EP - 170
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 1
ER -