TY - JOUR
T1 - Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma
AU - Gerson, James N.
AU - Villa, Diego
AU - Gerrie, Alina S.
AU - Chapani, Parv
AU - Li, Shaoying
AU - Medeiros, L. Jeffrey
AU - Wang, Michael
AU - Cohen, Jonathon B.
AU - Churnetski, Michael
AU - Hill, Brian T.
AU - Sawalha, Yazeed
AU - Hernandez-Ilizaliturri, Francisco J.
AU - Kothari, Shalin
AU - Vose, Julie M.
AU - Bast, Martin
AU - Fenske, Timothy
AU - Gari, Swapna Narayana Rao
AU - Maddocks, Kami J.
AU - Bond, David
AU - Bachanova, Veronika
AU - Kolla, Bhaskar
AU - Chavez, Julio
AU - Shah, Bijal
AU - Lansigan, Frederick
AU - Burns, Timothy
AU - Donovan, Alexandra M.
AU - Wagner-Johnston, Nina
AU - Messmer, Marcus
AU - Mehta, Amitkumar
AU - Anderson, Jennifer K.
AU - Reddy, Nishitha
AU - Kovach, Alexandra E.
AU - Landsburg, Daniel J.
AU - Glenn, Martha
AU - Inwards, David J.
AU - Ristow, Kay
AU - Karmali, Reem
AU - Kaplan, Jason B.
AU - Caimi, Paolo F.
AU - Rajguru, Saurabh
AU - Evens, Andrew
AU - Klein, Andreas
AU - Umyarova, Elvira
AU - Pulluri, Bhargavi
AU - Amengual, Jennifer E.
AU - Lue, Jennifer K.
AU - Diefenbach, Catherine
AU - Fisher, Richard I.
AU - Barta, Stefan K.
AU - Handorf, Elizabeth
N1 - © 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.
PY - 2023/12/26
Y1 - 2023/12/26
N2 - Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma; data indicate that blastoid and pleomorphic variants have a poor prognosis. We report characteristics and outcomes of patients with blastoid/pleomorphic variants of MCL. We retrospectively studied adults with newly diagnosed MCL treated from 2000 to 2015. Primary objectives were to describe progression-free survival (PFS) and overall survival (OS). Secondary objectives included characterization of patient characteristics and treatments. Of the 1029 patients with MCL studied, a total of 207 neoplasms were blastoid or pleomorphic variants. Median follow-up period was 82 months (range, 0.1-174 months); median PFS was 38 months (95% confidence interval [CI], 28-66) and OS was 68 months (95% CI, 45-96). Factors associated with PFS were receipt of consolidative autologous hematopoietic transplantation (auto-HCT; hazard ratio [HR], 0.52; 95% CI, 0.31-0.80; P < .05), MCL International Prognostic Index (MIPI) intermediate (HR, 2.3; 95% CI, 1.2-4.3; P < .02) and high (HR, 3.8; 95% CI, 2.0-7.4; P < .01) scores, and complete response to induction (HR, 0.29 (95% CI, 0.17-0.51). Receipt of auto-HCT was not associated with OS (HR, 0.69; 95% CI, 0.41-1.16; P = .16) but was associated with MIPI intermediate (HR, 5.7; 95% CI, 2.5-13.2; P < .01) and high (HR, 10.8; 95% CI, 4.7-24.9; P < .01) scores. We report outcomes in a large cohort of patients with blastoid/pleomorphic variant MCL. For eligible patients, receipt of auto-HCT after induction was associated with improved PFS but not OS. Higher MIPI score and auto-HCT ineligibility were associated with worse survival.
AB - Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma; data indicate that blastoid and pleomorphic variants have a poor prognosis. We report characteristics and outcomes of patients with blastoid/pleomorphic variants of MCL. We retrospectively studied adults with newly diagnosed MCL treated from 2000 to 2015. Primary objectives were to describe progression-free survival (PFS) and overall survival (OS). Secondary objectives included characterization of patient characteristics and treatments. Of the 1029 patients with MCL studied, a total of 207 neoplasms were blastoid or pleomorphic variants. Median follow-up period was 82 months (range, 0.1-174 months); median PFS was 38 months (95% confidence interval [CI], 28-66) and OS was 68 months (95% CI, 45-96). Factors associated with PFS were receipt of consolidative autologous hematopoietic transplantation (auto-HCT; hazard ratio [HR], 0.52; 95% CI, 0.31-0.80; P < .05), MCL International Prognostic Index (MIPI) intermediate (HR, 2.3; 95% CI, 1.2-4.3; P < .02) and high (HR, 3.8; 95% CI, 2.0-7.4; P < .01) scores, and complete response to induction (HR, 0.29 (95% CI, 0.17-0.51). Receipt of auto-HCT was not associated with OS (HR, 0.69; 95% CI, 0.41-1.16; P = .16) but was associated with MIPI intermediate (HR, 5.7; 95% CI, 2.5-13.2; P < .01) and high (HR, 10.8; 95% CI, 4.7-24.9; P < .01) scores. We report outcomes in a large cohort of patients with blastoid/pleomorphic variant MCL. For eligible patients, receipt of auto-HCT after induction was associated with improved PFS but not OS. Higher MIPI score and auto-HCT ineligibility were associated with worse survival.
KW - Patients with blastoid and pleomorphic variant MCL have suboptimal outcomes
KW - Receipt of auto-HCT, MIPI score
KW - complete response to induction were associated with PFS; auto-HCT was not associated with OS
UR - http://www.scopus.com/inward/record.url?scp=85180954726&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2023010757
DO - 10.1182/bloodadvances.2023010757
M3 - Article
C2 - 37874912
AN - SCOPUS:85180954726
SN - 2473-9529
VL - 7
SP - 7393
EP - 7401
JO - Blood advances
JF - Blood advances
IS - 24
ER -