Integrative analysis of clinicopathological features defines novel prognostic models for mantle cell lymphoma in the immunochemotherapy era: a report from The North American Mantle Cell Lymphoma Consortium.
Journal
Journal of hematology & oncology
ISSN: 1756-8722
Titre abrégé: J Hematol Oncol
Pays: England
ID NLM: 101468937
Informations de publication
Date de publication:
16 Dec 2023
16 Dec 2023
Historique:
received:
25
10
2023
accepted:
04
12
2023
medline:
17
12
2023
pubmed:
17
12
2023
entrez:
16
12
2023
Statut:
epublish
Résumé
Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes. The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases. In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p < 0.0001) and progression-free survival (PFS, p < 0.0001). P53 positive expression was the most significant pathological parameter correlating with inferior outcomes (p < 0.0001 for OS and p = 0.0021 for PFS). Based on the baseline risk factor profile, we developed a set of prognostic models incorporating clinical, laboratory, and pathological parameters that are specifically tailored for various applications. These models, when tested in the validation cohort, exhibited strong predictive power for survival and showed a stratification resembling the training cohort. The outcome of patients with MCL has markedly improved over the past two decades, and further enhancement is anticipated with the evolution of clinical management. The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes.
METHODS
METHODS
The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases.
RESULTS
RESULTS
In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p < 0.0001) and progression-free survival (PFS, p < 0.0001). P53 positive expression was the most significant pathological parameter correlating with inferior outcomes (p < 0.0001 for OS and p = 0.0021 for PFS). Based on the baseline risk factor profile, we developed a set of prognostic models incorporating clinical, laboratory, and pathological parameters that are specifically tailored for various applications. These models, when tested in the validation cohort, exhibited strong predictive power for survival and showed a stratification resembling the training cohort.
CONCLUSIONS
CONCLUSIONS
The outcome of patients with MCL has markedly improved over the past two decades, and further enhancement is anticipated with the evolution of clinical management. The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL.
Identifiants
pubmed: 38104096
doi: 10.1186/s13045-023-01520-7
pii: 10.1186/s13045-023-01520-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
122Informations de copyright
© 2023. The Author(s).
Références
Cancer Med. 2019 Nov;8(16):6860-6870
pubmed: 31560165
Blood. 2018 Jan 25;131(4):417-420
pubmed: 29196411
Am J Clin Pathol. 2008 Aug;130(2):166-77
pubmed: 18628084
Blood. 2008 Jan 15;111(2):558-65
pubmed: 17962512
J Clin Oncol. 2016 Apr 20;34(12):1386-94
pubmed: 26926679
Haematologica. 2016 Aug;101(8):e320-3
pubmed: 27081179
Leukemia. 2023 Sep;37(9):1887-1894
pubmed: 37495776
Leuk Lymphoma. 2014 Apr;55(4):802-10
pubmed: 23772666
J Natl Cancer Inst. 1994 Jun 1;86(11):829-35
pubmed: 8182763
Br J Haematol. 2018 Jun;181(5):703-706
pubmed: 28444739
Blood. 2008 Feb 15;111(4):2385-7
pubmed: 18077791
Br J Haematol. 2018 Oct;183(2):225-234
pubmed: 30080252
Mod Pathol. 2018 Feb;31(2):327-336
pubmed: 28984300
Lancet. 2016 Aug 6;388(10044):565-75
pubmed: 27313086
J Clin Oncol. 2005 Mar 20;23(9):1984-92
pubmed: 15668467
N Engl J Med. 2022 Jun 30;386(26):2482-2494
pubmed: 35657079
Cancer. 2006 Sep 1;107(5):1014-22
pubmed: 16878325
Leukemia. 1998 Aug;12(8):1281-7
pubmed: 9697885
Ann Oncol. 2010 Jan;21(1):133-9
pubmed: 20019090
Leukemia. 2001 Nov;15(11):1785-91
pubmed: 11681422
Am J Clin Pathol. 2014 Apr;141(4):593-604
pubmed: 24619762
Leuk Lymphoma. 2022 Dec;63(14):3504-3507
pubmed: 36059262
Blood Adv. 2020 Mar 10;4(5):858-867
pubmed: 32126141
Blood. 2018 Dec 27;132(26):2722-2729
pubmed: 30385481
Am J Hematol. 2017 Aug;92(8):806-813
pubmed: 28699667
Blood. 2017 Oct 26;130(17):1903-1910
pubmed: 28819011
J Clin Oncol. 2014 May 1;32(13):1338-46
pubmed: 24687837
Blood. 2020 Sep 17;136(12):1419-1432
pubmed: 32584970
Br J Haematol. 2020 Dec;191(5):796-805
pubmed: 32748433