The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT)

被引:137
作者
Geisler, Christian H. [1 ]
Kolstad, Arne [2 ]
Laurell, Anna [3 ]
Raty, Riikka [4 ]
Jerkeman, Mats [5 ]
Eriksson, Mikael [5 ]
Nordstrom, Marie [6 ]
Kimby, Eva [6 ]
Boesen, Anne Marie [7 ]
Nilsson-Ehle, Herman [8 ]
Kuittinen, Outi [9 ]
Lauritzsen, Grete F. [2 ]
Ralfkiaer, Elisabeth
Ehinger, Mats [5 ]
Sundstrom, Christer [3 ]
Delabie, Jan [2 ]
Karjalainen-Lindsberg, Marja-Liisa [4 ]
Brown, Peter
Elonen, Erkki [4 ]
机构
[1] Rigshosp, Dept Hematol 4042, DK-2100 Copenhagen, Denmark
[2] Norwegian Radium Hosp, Oslo, Norway
[3] Univ Uppsala Hosp, Uppsala, Sweden
[4] Univ Helsinki, Cent Hosp, Helsinki, Finland
[5] Univ Lund Hosp, S-22185 Lund, Sweden
[6] Karolinska Inst, Stockholm, Sweden
[7] Aarhus Univ Hosp, DK-8000 Aarhus, Denmark
[8] Sahlgrenska Hosp, Gothenburg, Sweden
[9] Oulu Univ Hosp, Oulu, Finland
关键词
PROGRESSION-FREE SURVIVAL; RITUXIMAB; MCL; THERAPY; RESCUE; KI67;
D O I
10.1182/blood-2009-08-236570
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Mantle cell lymphoma (MCL) has a heterogeneous clinical course. The recently proposed Mantle Cell Lymphoma International Prognostic Index (MIPI) predicted the survival of MCL better than the International Prognostic Index in MCL patients treated with conventional chemotherapy, but its validity in MCL treated with more intensive immunochemotherapy has been questioned. Applied here to 158 patients of the Nordic MCL2 trial of first-line intensive immunochemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation, the MIPI and the simplified MIPI (s-MIPI) predicted survival significantly better (P < .001) than the International Prognostic Index (P > .004). Both the MIPI and the s-MIPI mainly identified 2 risk groups, low and intermediate versus high risk, with the more easily applied s-MIPI being just as powerful as the MIPI. The MIPIB (biological), incorporating Ki-67 expression, identified almost half of the patients as high risk. We suggest that also a simplified MIPIB is feasible. This trial was registered at www.isrctn.org as #ISRCTN 87866680. (Blood. 2010;115:1530-1533)
引用
收藏
页码:1530 / 1533
页数:4
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