Evaluation of clinical parameters and biomarkers in older, untreated mantle cell lymphoma patients receiving bendamustine-rituximab.
Colleen A RamsowerAllison RosenthalRyan S RobetoryeRaphael MwangiMatthew John MaurerDiego R VillaTim McDonnellAndrew FeldmanJonathon B CohenThomas HabermannElias CampoGuillem ClotMarco M BühlerMarta KulisJosé Ignacio Martin-SuberoEva GinéJames R CookBrian T HillPhilipp W RaessKlaus H BeiskeAlexander ReichartSylvia HartmannHarald HolteDavid ScottLisa M RimszaPublished in: British journal of haematology (2023)
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.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- clinical trial
- chronic kidney disease
- prognostic factors
- physical activity
- randomized controlled trial
- stem cells
- signaling pathway
- diffuse large b cell lymphoma
- middle aged
- patient reported outcomes
- high grade
- high throughput
- bone marrow
- mesenchymal stem cells
- community dwelling
- chronic lymphocytic leukemia
- free survival
- fine needle aspiration