Novel Prognostic Models Provide Valuable Guidance for Mantle Cell Lymphoma Treatment Strategy

Findings from a Comprehensive Retrospective Analysis by The North American Mantle Cell Lymphoma Consortium

Innovative prognostic models can help boost and guide treatment strategy selection for patients with mantle cell lymphoma (MCL), according to findings from a comprehensive retrospective analysis by The North American Mantle Cell Lymphoma Consortium (NAMCLP). 

Julie M Vose, MD, MBA, Nebraska Medicine Fred and Pamela Buffett Cancer Center, Omaha, Nebraska, and coauthors stated, regarding the commonly used Mantle Cell Lymphoma International Prognostic Index (MIPI), “several disadvantages have been encountered in the practical application of this stratification method, which led to inconsistent results in validation studies.” They added, “commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease.”

The study authors aimed to explore the clinical and pathological features of MCL and create a novel set of prognostic models with higher predictive value for patient outcomes. This trial used 23 North American institutions in collaboration. A total of 586 patients with MCL were included in this study, which analyzed clinicopathological features, treatment strategies, and patient outcomes. New prognostic models were established based on a thorough analysis of baseline parameters and subsequent validation within a separate cohort of MCL patient cases. 

Results indicated that in frontline strategies, hematopoietic stem cell transplantation was the most significant variable correlated with overall survival and progression-free survival. Additionally, protein 53 (P53) positive expression was the most significant pathological parameter correlated with inferior overall survival and progression-free survival outcomes. 

A set of novel prognostic models using clinical, laboratory, and pathological variables tailored for various applications were formed contingent on an analysis of the baseline risk factor profile. After testing the predictive strength of these models in the validation cohort, the study authors noted that they demonstrated robust predictive power for survival and displayed a stratification similar to the training cohort. 

Vose and the study authors concluded, “The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL.” 

They went on, “Future studies are needed to incorporate genetic features into risk stratification, especially for the purpose of improving the administration of second-line and novel therapies.”

Source: 

Vose JM, Fu K, Wang L, et al. Integrative analysis of clinicopathological features defines novel prognostic models for mantle cell lymphoma in the immunochemotherapy era: a report from The North American Mantle Cell Lymphoma Consortium. J Hematol Oncol. Published online: December 16, 2023. doi: 10.1186/s13045-023-01520-7