Analysis of prognostic markers and survival data of patients with mantle cell lymphoma: A single-center experience

Abstract

Aim: The aim of this study was to share our experience about long-term outcome of patients with mantle cell lymphoma (MCL) who admitted to our center by analysing the disease characteristics, response to treatment and survival data.
Materials and Methods: A retrospective study was conducted on newly-diagnosed MCL patients who admitted at our centre between 2010 and 2017. Demographic and disease characeristics and response to treatment data were analyzed. Survival analysis was performed to determine the factors affecting survival.
Results: A total of 19 MCL patients were included in the study. 10 (52.6%) of the patients were male and 9 (47.4%) were female and the mean age was 65.47±10.72 (years). The median follow-up duration was 29.4 [2.5-84.0] months. While 8 patients (42.1%) had complete response (CR1) and 5 patients (26.3%) had partial response (PR), 6 patients (31.5%) were accepted as unresponsive to first line chemotherapy. Overall survival (OS) was 44.2 [5.9-282.5] months. Lactate dehydrogenase (LDH) level at the time of diagnosis and the achievement of CR1 were demonstrated to have significant effect on survival (Odds Ratio (OR): 1.007, 95%CI: 1.002-1.013; p=0.011 vs OR: 0.990, 95%CI: 0.000-0.312; p=0.009).
Conclusion: The results of this study demonstrated that higher LDH levels at the time of diagnosis and insufficient response to first-line treatment have negative effect on survival. Patients with those should be monitored more closely and their treatment regimens should be more intensive and individualized by adding new agents.

Keywords

• lymphoma,mantle,response,survival

Mantle hücreli lenfoma hastalarında prognostik belirteçler ve sağkalım analizi: Tek merkez deneyimi

Abstract

Amaç: Bu çalışmanın amacı, merkezimize başvuran mantle hücreli lenfoma (MHL) hastalarının hastalık özelliklerini, tedaviye yanıt oranlarını ve sağkalım verilerini inceleyerek, uzun vadeli sonuçlar hakkında deneyimimizi paylaşmaktır.
Gereç ve Yöntemler: Merkezimizde 2010-2017 yılları arasında yeni tanısı konulan MHL hastalarının verileri retrospektif olarak incelendi. Demografik ve hastalık verileri incelenerek hastalık özellikleri ve tedaviye yanıt oranları analiz edildi. Sağkalım analizleri yapılarak sağkalımı etkileyen faktörler araştırıldı.
Bulgular: Toplam 19 MHL tanısı alan hasta çalışmaya dahil edildi. Hastaların 10'u (%52.6) erkek, 9'u (%47.4) kadın ve ortalama yaş 65.47±10.72 (yıl) idi. Medyan takip süresi 29.4 [2.5-84.0] ay idi. 1. basamak kemoterapiye 8 hasta (%42.1) tam yanıt (TY1) ve 5 hasta (%26.3) kısmi yanıt (KY) verirken, 6 hasta (%31.5) ise yanıtsız kabul edildi. Genel sağkalım (OS) 44.2 [5.9-82.5] ay olarak bulundu. Hastaların tanı anındaki laktat dehidrogenaz (LDH) düzeylerinin ve birinci basamak kemoterapiye TY1 elde etme durumunun sağkalım sürelerine anlamlı etkisi olduğu görüldü (Odds Ratio (OR):1.007, %95CI:1.002-1.013; p=0.011 vs OR:0.990, %95CI:0.000-0.312; p=0.009).
Sonuç: Bu çalışmanın sonuçları; tanı anında yüksek LDH düzeylerinin ve ilk sıra tedaviye yetersiz yanıtın sağkalıma olumsuz etkisi olduğunu göstermektedir. Bu özelliklere sahip hastalar daha yakın takip edilmeli ve tedavi rejimleri daha yoğun ve yeni ajanlar eklenerek bireyselleştirilmelidir.

Keywords

• lenfoma,mantle,yanıt,sağkalım

References

1. 1. Inamdar AA, Goy A, Ayoub NM et al. Mantle cell lymphoma in the era of precision medicine-diagnosis, biomarkers and therapeutic agents. Oncotarget 2016; 7: 48692-731.
2. 2. Cheah CY, Seymour JF, Wang ML. Mantle Cell Lymphoma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2016; 34: 1256-69.
3. 3. Goy A. Mantle Cell Lymphoma: Is It Time for a New Treatment Paradigm? Hematology/oncology clinics of North America 2016; 30: 1345-70.
4. 4. Vose JM. Mantle cell lymphoma: 2017 update on diagnosis, risk-stratification, and clinical management. American journal of hematology 2017; 92: 806-13.
5. 5. Katz SG, Labelle JL, Meng H et al. Mantle cell lymphoma in cyclin D1 transgenic mice with Bim-deficient B cells. Blood 2014; 123: 884-93.
6. 6. Herrmann A, Hoster E, Zwingers T et al. Improvement of overall survival in advanced stage mantle cell lymphoma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2009; 27: 511-8.
7. 7. Tucker D, Rule S. Novel agents in mantle cell lymphoma. Expert Review of Anticancer Therapy 2017; 17: 491-506.
8. 8. Kluin-Nelemans HC, Hoster E, Hermine O et al. Treatment of older patients with mantle-cell lymphoma. The New England journal of medicine 2012; 367: 520-31.

9. 9. Nordstrom L, Sernbo S, Eden P et al. SOX11 and TP53 add prognostic information to MIPI in a homogenously treated cohort of mantle cell lymphoma--a Nordic Lymphoma Group study. British journal of haematology 2014; 166: 98-108.
10. 10. Vogt N, Dai B, Erdmann T et al. The molecular pathogenesis of mantle cell lymphoma. Leukemia & lymphoma 2017; 58: 1530-7.
11. 11. Hoster E, Dreyling M, Klapper W et al. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood 2008; 111: 558-65.
12. 12. Geisler CH, Kolstad A, Laurell A et al. The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT). Blood 2010; 115: 1530-3.
13. 13. Hoster E, Rosenwald A, Berger F et al. Prognostic Value of Ki-67 Index, Cytology, and Growth Pattern in Mantle-Cell Lymphoma: Results From Randomized Trials of the European Mantle Cell Lymphoma Network. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2016; 34: 1386-94.
14. 14. Nazeef M, Kahl BS. Mantle Cell Lymphoma: First-line Therapy in Patients Not Eligible for Stem Cell Transplantation. Current treatment options in oncology 2015; 16: 29.