TY - JOUR
T1 - Prognostic model for mantle cell lymphoma in the rituximab era
T2 - A nationwide study in Japan
AU - Chihara, Dai
AU - Asano, Naoko
AU - Ohmachi, Ken
AU - Kinoshita, Tomohiro
AU - Okamoto, Masataka
AU - Maeda, Yoshinobu
AU - Mizuno, Ishikazu
AU - Matsue, Kosei
AU - Uchida, Toshiki
AU - Nagai, Hirokazu
AU - Nishikori, Momoko
AU - Nakamura, Shigeo
AU - Ogura, Michinori
AU - Suzuki, Ritsuro
N1 - Publisher Copyright:
© 2015 John Wiley & Sons Ltd.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Mantle cell lymphoma (MCL) is essentially incurable with conventional chemotherapy. The MCL International Prognostic Index (MIPI) is a validated specific prognostic index, but was derived from patients with advanced-stage disease primarily in the pre-rituximab era. We analysed 501 MCL patients (median age, 67 years; range 22-90) treated with rituximab-containing chemotherapy, and evaluated the prognostic factors adjusted by the treatment. Five-year overall survival (OS) in the low, intermediate and high MIPI groups was 74%, 70% and 35%, respectively. Additional to MIPI risk factors, multivariate analysis revealed that low serum albumin and bone-marrow involvement were also significantly associated with a poor outcome. The revised-MIPI (R-MIPI) was constructed using six factors, namely age, performance status, white blood cell count, serum lactate dehydrogenase, bone-marrow involvement and serum albumin, which is divided into four prognostic groups. Five-year OS in low, low-intermediate (L-I), high-intermediate (H-I) and high R-MIPI groups was 92%, 75%, 61% and 19%, respectively. Hazard ratio for OS of L-I, H-I and high risk to low risk patients were 5·4, 8·3 and 33·0, respectively. R-MIPI, a new prognostic index with easy application to the general patient population, shows promise for identifying low- and high-risk MCL patients in the rituximab era.
AB - Mantle cell lymphoma (MCL) is essentially incurable with conventional chemotherapy. The MCL International Prognostic Index (MIPI) is a validated specific prognostic index, but was derived from patients with advanced-stage disease primarily in the pre-rituximab era. We analysed 501 MCL patients (median age, 67 years; range 22-90) treated with rituximab-containing chemotherapy, and evaluated the prognostic factors adjusted by the treatment. Five-year overall survival (OS) in the low, intermediate and high MIPI groups was 74%, 70% and 35%, respectively. Additional to MIPI risk factors, multivariate analysis revealed that low serum albumin and bone-marrow involvement were also significantly associated with a poor outcome. The revised-MIPI (R-MIPI) was constructed using six factors, namely age, performance status, white blood cell count, serum lactate dehydrogenase, bone-marrow involvement and serum albumin, which is divided into four prognostic groups. Five-year OS in low, low-intermediate (L-I), high-intermediate (H-I) and high R-MIPI groups was 92%, 75%, 61% and 19%, respectively. Hazard ratio for OS of L-I, H-I and high risk to low risk patients were 5·4, 8·3 and 33·0, respectively. R-MIPI, a new prognostic index with easy application to the general patient population, shows promise for identifying low- and high-risk MCL patients in the rituximab era.
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U2 - 10.1111/bjh.13486
DO - 10.1111/bjh.13486
M3 - Article
C2 - 25953436
AN - SCOPUS:84938949995
SN - 0007-1048
VL - 170
SP - 657
EP - 668
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 5
ER -