Clinical Features,Treatment Protocols And Prognostic Factors Of 83 Cases Of Mantle Cell Lymphoma

Objective:As a relatively rare non-Hodgkin's lymphoma,mantle cell lymphoma(MCL)is difficult to cure as well as agressive.Patients with MCL frequently have a poor prognosis.Now we retrospectively analyzed the clinical data,follow-up information,treatment protocols and prognostic factors of the newly diagnosed MCL patients in our hospital over the past 5 years.Methods:A total of 83 cases of newly diagnosed mantle cell lymphoma which were confirmed by pathology department of our hospital between January 1,2011 and May 30,2016 were enrolled.Clinical characteristics of all patients were summarized.Prognostic analysis were conducted on the clinical features,laboratory examination and treatment protocols of 75 patients.Results:(1)Among the 83 MCL patients,the median age was 59 years and the ratio of male to female was about 7:1.82 cases(98.8%)present with Ann Arbor stage ???.Extranodal involvement were seen in 61 cases(73.5%)among which bone marrow were most commonly involved(36 cases,43.4%),followed by gastrointestinal tract(28.9%).(2)Treatment protocols of 75 patients were analyzed.The ORR(P=0.025)and PFS(P=0.030)in RCHOP-like group was significantly superior than that in CHOP-like group,and the overall mortality was significantly higher in CHOP-like group(P=0.015).However,the difference in OS between two groups had no statistical significance(P=0.063).Besides,patients in RHyperCVAD group had significantly higher PFS(P=0.015)and OS(P=0.002)than those in HyperCVAD group,and the overall mortality was significantly higher in HyperCVAD group(P=0.014).However,no statistical difference was seen in ORR between two groups.Besides,ORR(P=0.324),PFS(P=0.163),OS(P=0.570)and overall mortality(P=0.834)between HyperCVAD-based regimens and CHOP-based regimens were of no statistical difference.(3)Age,B symptoms,MIPI score,white blood cell count,platelet count,monocyte count,?2-microglobulin level,albumin level,C reactive protein level had significant effect on OS in MCL patients(P<0.05).With these factors included in the COX regression analysis,MIPI score(P=0.018,95%CI:0.051?0.752)was found to be an independent factor associated with OS in MCL patients.Conclusion:MCL is a subtype of non-Hodgkin lymphoma with high heterogeneity,mostly common in elderly male.The majority of patients present with stage ??? at diagnosis.We found that the combined chemotherapy containing rituximab was significantly more effective than chemotherapy alone and significantly improved prognosis and reduced overall mortality.ORR,PFS,OS and overall mortality between HyperCVAD-based regimens and CHOP-based regimens were of no statistical difference.MIPI is an independent predictor of OS in patients with MCL,and should be given high priority in prognosis stratification.