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Confirmation of the Mantle-Cell Lymphoma International Prognostic Index in Randomized Trials of the European Mantle-Cell Lymphoma Network
- Source :
- Journal of Clinical Oncology, 32(13), 1338-1346. American Society of Clinical Oncology, Journal of Clinical Oncology, 32(13), 1338-1346. AMER SOC CLINICAL ONCOLOGY
- Publication Year :
- 2014
-
Abstract
- Purpose Mantle-cell lymphoma (MCL) is a distinct B-cell lymphoma associated with poor outcome. In 2008, the MCL International Prognostic Index (MIPI) was developed as the first prognostic stratification tool specifically directed to patients with MCL. External validation was planned to be performed on the cohort of the two recently completed randomized trials of the European MCL Network. Patients and Methods Data of 958 patients with MCL (median age, 65 years; range, 32 to 87 years) treated upfront in the trials MCL Younger or MCL Elderly were pooled to assess the prognostic value of MIPI with respect to overall survival (OS) and time to treatment failure (TTF). Results Five-year OS rates in MIPI low, intermediate, and high-risk groups were 83%, 63%, and 34%, respectively. The hazard ratios for OS of intermediate versus low and high versus intermediate risk patients were 2.1 (95% CI, 1.5 to 2.9) and 2.6 (2.0 to 3.3), respectively. MIPI was similarly prognostic for TTF. All four clinical baseline characteristics constituting the MIPI, age, performance status, lactate dehydrogenase level, and WBC count, were confirmed as independent prognostic factors for OS and TTF. The validity of MIPI was independent of trial cohort and treatment strategy. Conclusion MIPI was prospectively validated in a large MCL patient cohort homogenously treated according to recognized standards. As reflected in current guidelines, MIPI represents a generally applicable prognostic tool to be used in research as well as in clinical routine, and it can help to develop risk-adapted treatment strategies to further improve clinical outcome in MCL.
- Subjects :
- Male
Oncology
Cancer Research
Lymphoma, Mantle-Cell
THERAPY
Dexamethasone
Cohort Studies
Antibodies, Monoclonal, Murine-Derived
RETROSPECTIVE ANALYSIS
International Prognostic Index
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
CYCLOPHOSPHAMIDE
Multicenter Studies as Topic
Randomized Controlled Trials as Topic
Aged, 80 and over
Hazard ratio
Cytarabine
Chemoradiotherapy
Middle Aged
Prognosis
Vincristine
SURVIVAL
Female
Rituximab
Cohort study
medicine.drug
Adult
medicine.medical_specialty
IMMUNOCHEMOTHERAPY
VALIDATION
Internal medicine
medicine
Humans
RITUXIMAB
Aged
Neoplasm Staging
Proportional Hazards Models
RESPONSE CRITERIA
Peripheral Blood Stem Cell Transplantation
business.industry
Proportional hazards model
TRANSPLANTATION
MIPI
medicine.disease
Lymphoma
Surgery
Transplantation
Doxorubicin
Prednisone
Mantle cell lymphoma
Cisplatin
business
Subjects
Details
- Language :
- English
- ISSN :
- 0732183X
- Volume :
- 32
- Issue :
- 13
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....abb45dc50888eff8bd14f032dc3937ef