Analysis Of Clinical Features And Prognosis Of 89 Patients With Mantle Cell Lymphoma

Purpose:Mantle cell lymphoma(MCL),a special type of non-Hodgkin’s lymphoma,has characteristics of both indolent and aggressive lymphomas.MCL is incurable through conventional treatment and its prognosis is poor.This study aimed to analyze the clinical features,therapeutic responses,and prognosis of patients with MCL in our hospital.Method:Clinical data of 89 patients with MCL in Fujian Medical University Union Hospital between January 2010 and December 2016 were retrospectively analyzed.The objective response rate(ORR)and overall survival(OS)were observed to analyze the clinical prognostic factors.Result:The median age of the 89 patients was 59 years(range,39-80 years old),and the male to female ratio was 2.87(66:23).All patients had Cyclin D1 over-expression or t(11;14)(q13;32),57 cases(64.04%)had superficial lymph node involvement at onset,55(61.80%)had bone marrow involvement,6(6.74%)had gastrointestinal involvement,and 51(57.30%)had splenomegaly.MIPI defined three prognostic groups : low,intermediate and high risk,that included 44.94%,23.60% and 31.46% of patients with median OS of 65,49,6 months respectively.There was a significant difference among the three MIPI staged groups(P=0.000).The modified combination of the Ki-67 index and MIPI(MIPI-c)defined four prognostic groups:low,low-intermediate,high-Intermediate and high risk,that included 24.24%,30.30%,22.73%,and 22.73% of patients with median OS rates of not reached,55,54,6months respectively.There was a significant difference between the four MIPI-c staged groups(P=0.000).Univariate analysis showed that age(P = 0.020),gender(P=0.017),ECOG performance status(P=0.000),bone marrow involvement(P=0.040),Ann Arbor Stage(P=0.049),LDH level(P=0.000),WBC(P=0.003),LYM(P=0.023),β2-MG(P=0.006)and Ki-67 level(P=0.032)were associated with prognosis.Multivariable Cox regression showed that age,gender,ECOG,LDH level were associated with prognosis(P<0.05).The treatment responses in the 63 evaluable patients were as follows: CR in 17 patients(26.98%),PR in 27 patients(39.68%),SD in 13 patients(20.63%),and PD in 8 patients(12.70%).The objective response rate(ORR)were significantly higher in patients receiving Hyper-CVAD/MA±R than in those undergoing CHOP±R(94.12%vs 58.06%,P = 0.009).There was significant difference in ORR between chemotherapy combined with or without rituximab(80% vs 46.15% P=0.040).Conclusion:Most patients with MCL were elderly,in an advanced stage,showed a male predominance,and usually had bone marrow involvement,gastrointestinal involvement,or splenomegaly.Hyper-CVAD/MA±R and rituximab combined with chemotherapy regimen could improve the ORR of MCL patients.Age,gender,ECOG,LDH level were associated with prognosis.The MIPI、MIPI-c can predict the prognosis of MCL.