Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival,independent of the MCL international prognostic index |
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Authors: | Fabrice Jardin Isabelle Radford Catherine Roche‐Lestienne Dominique Penther Christian Bastard Sophie Rigaudeau Sylvain Pilorge Franck Morschhauser Didier Bouscary Richard Delarue Hassan Farhat Philippe Rousselot Olivier Hermine Hervé Tilly Sylvie Chevret Sylvie Castaigne |
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Affiliation: | 1. Department of Hematology and INSERM U918, Centre Henri Becquerel, Rouen, France;2. Department of Cytogenetics, Necker Hospital, AP‐HP, Paris, France;3. Department of Cytogenetics, Centre Hospitalier de Lille, Lille, France;4. Department of Cytogenetics, Centre Hospitalier Henri Becquerel, Rouen, France;5. Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, Université de Versailles‐Saint Quentin, Versailles, France;6. Department of Hematology, Centre Hospitalier de Lille, Lille, France;7. Department of Hematology, Cochin Hospital, AP‐HP, Paris, France;8. Department of Hematology, Necker Hospital, AP‐HP, Paris, France;9. Department of Biostatistics, Saint Louis Hospital, AP‐HP, Université Paris‐Diderot, Paris, France |
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Abstract: | Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an “indolent” evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra‐hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of “indolent” patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. © 2013 Wiley Periodicals, Inc. |
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