Clinical Features And Prognostic Analysis In Mantle Cell Lymphoma

Objective: To study the clinic pathologic features, therapeutic effects, overall survival, and prognosis in patients with mantle cell lymphoma(MCL).Methods:37 MCL hospitalized in Zhangzhou Affiliated Hospital of Fujian Medical University from January 2005 to December 2015 were enrolled to this study. Clinical features, chemotherapy regimen, overall survival and prognostic factors were analyzed. Statistic was analyzed by SPSS 19.0. P<0.05 was considered significant.Results: 37 MCL cases were age range 38-76 years old,(media age was 61y), and men 28 and female 9 cases. The superficial lymph node involvement was common. The extranodal involvement included bone marrow 14 cases(37.84%), spleen 22 cases(59.46%), and gastrointestinal tract 9 cases, nasopharynx 5 cases(13.51%). 4 cases(10.81%) were in Ann Arbor stage ?-?, 15(40.54%) in stage III, and 18(48.65%) in stage IV. Overall survival in different stage was significantly different(65.9months vs. 50.57 months vs. 28.43 months, P=0.004). 8 cases(21.62%) in lower risk in MIPI scores, 10 cases(27.03%) in medium risk and 19 cases(51.35%) in higher risk. Overall survival in different risk was significantly different(65.9 months vs. 53.8 months vs. 29.87 months P=0.008). 12 cases(32.43%) was with KI-67?50%, and 25(67.57%) with Ki-67<50%. Overall survival in patients with Ki-67<50% is better than that with Ki-67 >50 %( 42.67 months vs. 29.67 months, P=0.018). B symptoms, elevated ?2-MG, elevated LYM counts, IPI scores, spleen, bone marrow involvement were poor prognostic factors(P<0.05). WBC and LDH didn't involved in prognosis(P>0.05). All above the clinical characteristics had little involved in short-term efficacy(P>0.05). 30 cases received chemotherapy at least 4 to 6 courses. 7 of them received chemotherapy plus Rituximab, ORR was 57.1%. 23 of them without Rituximab were with ORR 69.6%(P>0.05).Conclusion:MCL is a rare subtype of small B cell non-Hodgkin's lymphoma. It has a predilection to occur in old men. Most of them were in stage III/IV at first diagnosis, and with extensive extranodal involvement, and with a poor prognosis. Ann Arbor stage, ECOG score 2-4, B symptoms, bone marrow, spleen involvement, with Lymphoma leukemia, elevated ?2-MG, elevated LYM counts, Ki-67?50%, higher MIPI and IPI scores were poor prognostic factors(P<0.05), but not involve in respond rate. Multivariate Cox analysis shows that LYM counts, with Lymphoma leukemia, B symptoms, ECOG score had a worse prognosis(P<0.05). The conventional regimen CHOP and/or Rituximab have little improved prognosis in MCL.