Clinical features and prognosis-related factors of mantle cell lymphoma in elderly patients
ZHANG Lingling1,LIU Ninghong2,and LIANG Jun1
1.Department of Oncology, Peking University International Hospital, Beijing 102206,China; 2.Department of Oncology, Beijing Geriatric Hospital, Beijing 100095,China
Abstract：Objective To study the clinical features as well as therapeutic outcomes of elderly patients with mantle cell lymphoma (MCL) , identify the major prognostic factors and to explore the optimal approach.Methods We retrospectively analyzed 45 patients diagnosed with MCL in two hospitals between 2000 and 2007. Clinical data, including age,stage,performance status,international prognostic index,treatment modalities and clinical outcomes, were evaluated.Results The median age of the patients was 73 years (aged 60 to 84). The ratio of males to females was 3.3∶1. All the patients received combined chemotherapy. With a median follow-up of 38 months, the rates of 5-year overall and 2-year disease-free survivals were 17.3% and 27.2%, respectively. None remained disease-free at year 3. Median progression free survival was 20 months. There was no significant difference between the patients who had received CHOP regimen or R-CHOP regimen. Univariate analysis showed that PS, serum LDH levels, existence of B symptoms, bone marrow and peripheral blood involvement were the prognostic factors of overall survival for MCL patients. Cox regression multivariable analysis showed that only PS and bone marrow involvement were of statistic significance for prognosis.Conclusions Elderly patients with MCL are usually characterized by late staging, poor curative effect, and short survival.PS and bone marrow involvement are independent risk factors which affect the prognosis of elderly patients with MCL.MCL cannot be cured by standard CHOP or R-CHOP regimen. Newly diagnosed patients should be treated with novel modalities in order to improve the outcomes.
Sg＇ korová A, Pytlík R, Móciková H,et al. Staging and treatment response evaluation in malignant lymphomas-czech lymphoma study group recommendations[J]. Klin Onkol,2016,29(4):295-302.
[4]
Hagemeister F B. Treatment of relapsed aggressive lymphomas: regimens with and without high-dose therapy and stem cell rescue[J]. Cancer Chemother Pharmacol,2002,49(11):13-20.
[5]
Sander B, Quintanilla-Martinez L, Ott G, et al. Mantle cell lymphoma--a spectrum from indolent to aggressive disease[J]. Virchows Arch,2016,468(3):245-257.
[6]
Shah B D, Martin P, Sotomayor E M. Mantle cell lymphoma: a clinically heterogeneous disease in need of tailored approaches[J]. Cancer Control,2012,19(3):227-235.
[7]
Cheah C Y, Seymour J F, Wang M L. Mantle Cell Lymphoma[J]. J Clin Oncol,2016,34(11):1256-1269.
[8]
Lenz G, Dreyling M, Hoster E, et al. Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG) [J]. J Clin Oncol, 2005,23(9):1984-1992.
[9]
Howard O M, Gribben J G, Neuberg D S, et al. Rituximab and CHOP induction therapy for newly diagnosed mantle-cell lymphoma: Molecular complete responses are not predictive of progression-free survival[J]. J Clin Oncol, 2002,20(5):1288-1294.
[10]
Rosenbluth B D, Yahalom J. Highly effective local control and palliation of mantle cell lymphoma with involved-field radiation therapy (IFRT) [J]. Int J Radiat Oncol Biol Phys, 2006,65(4):1185-1191.
[11]
Robak T, Huang H Q, Jin J, et al. Bortezomib based therapy for newly diagnosed mantle cell lymphoma[J]. New Engl Med,2015,372(10):944-953.
[12]
Kluin H C, Hoster E, Hermine O, et al. Treatment of older patients with mantle cell lymphoma[J]. New Engl J Med,2012,367(6):520-531.
[13]
Ruan J, Martin P, Shah B, et al. Lenalidomide plus Rituximab as initial treatment for mantle cell lymphoma[J]. New Engl J Med,2015,373(19):1835-1844.
[14]
Tiemann M, Schrader C, Klapper W, et al. Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma(MCL):a clinicopathological study from the European MCL Network[J].Br J Haematol, 2005,131(1):29-38.
2017, Vol. 28 
