Universität zu Köln

Hoster, Eva ORCID: 0000-0002-0749-1389, Rosenwald, Andreas, Berger, Francoise, Bernd, Heinz-Wolfram, Hartmann, Sylvia, Loddenkemper, Christoph, Barth, Thomas F. E., Brousse, Nicole, Pileri, Stefano, Rymkiewicz, Grzegorz ORCID: 0000-0002-3478-8014, Kodet, Roman, Stilgenbauer, Stephan, Forstpointner, Roswitha, Thieblemont, Catherine ORCID: 0000-0002-9941-2448, Hallek, Michael, Coiffier, Bertrand, Vehling-Kaiser, Ursula, Bouabdallah, Reda, Kanz, Lothar, Pfreundschuh, Michael, Schmidt, Christian, Ribrag, Vincent, Hiddemann, Wolfgang, Unterhalt, Michael, Kluin-Nelemans, Johanna C., Hermine, Olivier ORCID: 0000-0003-2574-3874, Dreyling, Martin H. and Klapper, Wolfram (2016). Prognostic Value of Ki-67 Index, Cytology, and Growth Pattern in Mantle-Cell Lymphoma: Results From Randomized Trials of the European Mantle Cell Lymphoma Network. J. Clin. Oncol., 34 (12). S. 1386 - 1396. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose Mantle-cell lymphoma (MCL) is a rather aggressive B-cell malignancy whose considerable variability of individual outcome is associated with clinical characteristics (Mantle Cell Lymphoma International Prognostic Index [MIPI]). The Ki-67 index is a strong independent prognostic factor; however, the biologic MIPI (MIPI-b) distinguishes only two groups, which does not appropriately depict the clinical heterogeneity. By using the cohort from the European MCL Younger and MCL Elderly trials, we aimed to evaluate the additional prognostic impact of cytology and growth pattern and to improve risk stratification with the Ki-67 index and MIPI. Patients and Methods Diagnostic tumor biopsies were reviewed by the European Mantle Cell Lymphoma Pathology Panel to determine Ki-67 index by using published guidelines, cytology, and growth pattern. We evaluated prognostic effects for overall survival (OS) by Cox regression. For the cohort used for MIPI-b development (German Low-Grade Lymphoma Study Group [GLSG] 1996 and GLSG2000), we checked whether the equally weighted combination of Ki-67 index (dichotomized at the validated 30% cutoff) and MIPI risk groups was adequate and compared the prognostic power of this modified combination to MIPI and MIPI-b for the MCL Younger/MCL Elderly cohort. Results The Ki-67 index was assessed in 508 of 832 patients (median age, 62 years). Blastoid cytology was associated with inferior OS independently of MIPI but not independently of the Ki-67 index. Growth pattern was not independently prognostic. The modified combination of the Ki-67 index and MIPI separated four groups with 5-year OS: 85%, 72%, 43%, and 17% (P < .001) and was more discriminative than MIPI and MIPI-b. Conclusion Using the Ki-67 index is superior to using cytology and growth pattern as prognostic factors in MCL. The modified combination of the Ki-67 index and MIPI showed a refined risk stratification, reflecting their strong complementary prognostic effects while integrating the most relevant prognostic factors available in clinical routine. (C) 2016 by American Society of Clinical Oncology

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoster, Eva UNSPECIFIED orcid.org/0000-0002-0749-1389 UNSPECIFIED Rosenwald, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Berger, Francoise UNSPECIFIED UNSPECIFIED UNSPECIFIED Bernd, Heinz-Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Sylvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Loddenkemper, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Barth, Thomas F. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brousse, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED Pileri, Stefano UNSPECIFIED UNSPECIFIED UNSPECIFIED Rymkiewicz, Grzegorz UNSPECIFIED orcid.org/0000-0002-3478-8014 UNSPECIFIED Kodet, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Stilgenbauer, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Forstpointner, Roswitha UNSPECIFIED UNSPECIFIED UNSPECIFIED Thieblemont, Catherine UNSPECIFIED orcid.org/0000-0002-9941-2448 UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Coiffier, Bertrand UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehling-Kaiser, Ursula UNSPECIFIED UNSPECIFIED UNSPECIFIED Bouabdallah, Reda UNSPECIFIED UNSPECIFIED UNSPECIFIED Kanz, Lothar UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfreundschuh, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ribrag, Vincent UNSPECIFIED UNSPECIFIED UNSPECIFIED Hiddemann, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Unterhalt, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Kluin-Nelemans, Johanna C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermine, Olivier UNSPECIFIED orcid.org/0000-0003-2574-3874 UNSPECIFIED Dreyling, Martin H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klapper, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-278453
DOI:	10.1200/JCO.2015.63.8387
Journal or Publication Title:	J. Clin. Oncol.
Volume:	34
Number:	12
Page Range:	S. 1386 - 1396
Date:	2016
Publisher:	AMER SOC CLINICAL ONCOLOGY
Place of Publication:	ALEXANDRIA
ISSN:	1527-7755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMPROVES RESPONSE; MCL-NETWORK; PROLIFERATION; SURVIVAL; IMMUNOCHEMOTHERAPY; MIPI; CYCLOPHOSPHAMIDE; VINCRISTINE; DOXORUBICIN; VALIDATION Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27845