A novel scoring system, using clinical and biological characterization, may aid in determining mantle cell lymphoma (MCL) prognosis, according to research presented during the ASCO20 Virtual Scientific Program.
The North American Mantle Cell Lymphoma Project was developed to help determine clinical and biological factors that affect MCL prognosis. Data were retrospectively analyzed, and were obtained from 589 patients diagnosed with MCL between 2000 and 2012 at 1 of 23 US institutions.
Among all included patients, the median age was 63 years (range, 24-104). While some data were not available for all 589 patients, 452 of 577 (78.3%) patients with gender data were men, 483 of 542 (89.1%) had Ann Arbor stage III to IV disease at diagnosis, 126 of 449 (28%) presented with B symptoms, and 394 of 546 (72%) had extranodal involvement at diagnosis.
The overall median follow-up was 5.2 years and the 5-year progression-free and overall survival rates (PFS and OS, respectively) were 24.1% and 60.2%, respectively.
Upon univariate analysis, the following factors were associated with worse PFS and OS:
- age at least 60 years
- B symptoms
- advanced Ann Arbor stage
- elevated lactate dehydrogenase levels
- low platelet counts
- blastoid or pleomorphic cytology
- Ki67 proliferation of at least 30%
- circulating tumor cell presence
- not having undergone transplantation
- undergoing allogeneic, rather than autologous, stem cell transplantation
The factors associated with worse overall survival (OS) were:
- large tumor size, defined by a diameter greater than 3 cm
- high WBC count
- being CD5- or CD23-positive
- complex karyotype
Age 60 years or older (hazard ratio [HR], 2.44) and elevated lactate dehydrogenase levels (HR, 2.19) were the 2 factors that best predicted clinical outcome.
Using data from 108 patients, the researchers designed MIPI-P, a novel scoring system for determining MCL prognosis, which included 3 groups: low grade (0-1 points; 11.8-year median OS), intermediate grade (2-3 points; 4.9-year median OS), and high grade (4-5 points; 1.6-year median OS).
Further analysis using data from 33 patients confirmed MIPI-P as a highly predictive scoring system (P =.014).
Fu K, Yu G, Bi C, et al. Mantle cell lymphoma: initial report from the North American Mantle Cell Lymphoma Consortium. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl): abstr 8035).
This article originally appeared on Hematology Advisor