Clinical outcome of Mantle Cell Lymphoma patients with high-risk disease (high-risk MIPI-c or high p53 expression)

被引：29

作者：

Scheubeck, Gabriel ^{[1
]}

Jiang, Linmiao ^{[2
]}

Hermine, Olivier ^{[3
]}

Kluin-Nelemans, Hanneke C. ^{[4
]}

Schmidt, Christian ^{[1
]}

Unterhalt, Michael ^{[1
]}

Rosenwald, Andreas ^{[5
]}

Klapper, Wolfram ^{[6
]}

Evangelista, Andrea ^{[7
,8
]}

Ladetto, Marco ^{[9
]}

Jerkeman, Mats ^{[10
]}

Ferrero, Simone ^{[11
]}

Dreyling, Martin ^{[1
]}

Hoster, Eva ^{[1
,2
]}

机构：

[1] LMU Univ Hosp, Dept Med 3, Munich, Germany

[2] Ludwig Maximilians Univ Munchen, Inst Med Informat Proc Biometry & Epidemiol, Munich, Germany

[3] Univ Hosp, Paris, France

[4] Univ Groningen, Univ Med Ctr Groningen, Dept Hematol, Groningen, Netherlands

[5] Univ Wurzburg, Inst Pathol, Wurzburg, Germany

[6] Univ Hosp Schleswig Holstein, Dept Pathol, Hematopathol Sect, Campus Kiel, Kiel, Germany

[7] Azienda Osped Univ Citta Salute & Sci, Unit Clin Epidemiol, Turin, Italy

[8] CPO Piemonte, Turin, Italy

[9] Azienda Osped SS Antonio & Biagio & Cesare Arrigo, Hematol, Alessandria, Italy

[10] Skane Univ Hosp, Lund, Sweden

[11] Univ Torino, Dept Mol Biotechnol & Hlth Sci, Div Hematol, AOU Citta Salute & Sci Torino, Turin, Italy

来源：

LEUKEMIA | 2023年 / 37卷 / 9期

关键词：

HIGH-DOSE CYTARABINE; PROGNOSTIC INDEX; OLDER PATIENTS; FOLLOW-UP; KI-67; TP53; IMMUNOCHEMOTHERAPY; TRANSPLANTATION; MUTATIONS; YOUNGER;

D O I：

10.1038/s41375-023-01977-y

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Currently, treatment allocation of patients with Mantle Cell Lymphoma (MCL) is mainly based on age and medical fitness. The combined MCL International Prognostic Index (MIPI-c) allows to predict prognosis using clinical factors (MIPI) and the Ki-67 index. However, high p53 expression as surrogate for TP53 alterations has demonstrated to be an independent predictor for poor outcome. We aimed to define a clear high-risk group based on the combination of MIPI, Ki-67 and p53 expression/TP53 alteration. A total of 684 patients from the prospective European MCL-Younger and MCL-Elderly trials were evaluable. The classification of high-risk disease (HRD) as high-risk MIPI-c or p53 expression >50% versus low-risk disease (LRD) as low, low-intermediate or high-intermediate MIPI-c and p53 expression & LE;50% allowed to characterize two distinct groups with highly divergent outcome. Patients with HRD had significantly shorter median failure-free survival (FFS) (1.1 vs. 5.6 years, p < 0.0001) and overall survival (OS) (2.2 vs. 13.2 years, p < 0.0001) compared to those with LRD. These major differences were confirmed in two validation cohorts from the Italian MCL0208 and the Nordic-MCL4 trials. The results suggest that this subset of HRD patients is not sufficiently managed with the current standard treatment and is asking for novel treatment strategies.

引用

页码：1887 / 1894

页数：8

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