A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma

被引：727

作者：

Hoster, Eva ^{[1
]}

Dreyling, Martin ^{[1
,2
]}

Klapper, Wolfram ^{[3
]}

Gisselbrecht, Christian ^{[4
]}

van Hoof, Achiel ^{[5
]}

Kluin-Nelemans, Hanneke C. ^{[6
]}

Pfreundschuh, Michael ^{[7
]}

Reiser, Marcel ^{[8
]}

Metzner, Bernd ^{[9
]}

Einsele, Hermann ^{[10
]}

Peter, Norma ^{[11
]}

Jung, Wolfram ^{[12
]}

Woermann, Bernhard ^{[13
]}

Ludwig, Wolf-Dieter ^{[14
]}

Duehrsen, Ulrich ^{[15
]}

Eimermacher, Hartmut ^{[16
]}

Wandt, Hannes ^{[17
]}

Hasford, Joerg ^{[2
]}

Hiddemann, Wolfgang ^{[1
]}

Unterhalt, Michael ^{[1
]}

机构：

[1] Univ Munich, Klinikum Grosshadern, Med Klin 3, Dept Internal Med 3, D-81377 Munich, Germany

[2] Univ Munich, Dept Med Informat Biometry & Epidemiol, D-81377 Munich, Germany

[3] Univ Kiel, Inst Pathol, Lymph Node Registry, D-2300 Kiel, Germany

[4] Hop St Louis, Dept Hematol, Paris, France

[5] Akad Ziekenhuis St Jan, Dept Hematol, Brugge, Belgium

[6] Univ Groningen, Med Ctr, Dept Hematol, Groningen, Netherlands

[7] Univ Saarland, Sch Med, Dept Internal Med, D-6650 Homburg, Germany

[8] Univ Cologne, Dept Internal Med 1, Cologne, Germany

[9] Klin Oldenburg, Dept Hematol & Oncol, Oldenburg, Germany

[10] Univ Hosp Wurzburg, Dept Internal Med 2, Wurzburg, Germany

[11] Carl Thiem Hosp, Dept Hematol Oncol, Cottbus, Germany

[12] Univ Gottingen, Dept Hematol & Oncol, Gottingen, Germany

[13] Klinikum Stadt Braunschweig, Braunschweig, Germany

[14] HELIOS Klin, Dept Hematol & Oncol, Berlin, Germany

[15] Univ Hosp Essen, Dept Hematol, Essen, Germany

[16] Kathol Krankenhaus Hagen, Dept Hematol & Oncol, Hagen, Germany

[17] Klinikum Nurnberg Nord, Med Dept 5, Nurnberg, Germany

来源：

BLOOD | 2008年 / 111卷 / 02期

关键词：

D O I：

10.1182/blood-2007-06-095331

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

There is no generally established prognostic index for patients with mantle cell lymphoma (MCL), because the International Prognostic Index (IPI) and Follicular Lymphoma International Prognostic Index (FLIPI) have been developed for diffuse large cell and follicular lymphoma patients, respectively. Using data of 455 advanced stage MCL patients treated within 3 clinical trials, we examined the prognostic relevance of IPI and FLIPI and derived a new prognostic index (MCL international prognostic index, MIPI) of overall survival (OS). Statistical methods included Kaplan-Meier estimates and the log-rank test for evaluating IPI and FLIPI and multiple Cox regression for developing the MIPI. IPI and FLIPI showed poor separation of survival curves. According to the MIPI, patients were classified into low risk (44% of patients, median OS not reached), intermediate risk (35%, 51 months), and high risk groups (21%, 29 months), based on the 4 independent prognostic factors: age, performance status, lactate dehydrogenase (LDH), and leukocyte count. Cell proliferation (Ki-67) was exploratively analyzed as an important biologic marker and showed strong additional prognostic relevance. The MIPI is the first prognostic index particularly suited for MCL patients and may serve as an important tool to facilitate risk-adapted treatment decisions in patients with advanced stage MCL.

引用

页码：558 / 565

页数：8

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