Prognostic impact of proliferative index determined by quantitative image analysis and the international prognostic index in patients with mantle cell lymphoma

R. Schaffel, C. V. Hedvat, J. Teruya-Feldstein, D. Persky, J. Maragulia, D. Lin, C. S. Portlock, C. H. Moskowitz, A. D. Zelenetz

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Background: The proliferative index (PI) is a powerful prognostic factor in mantle cell lymphoma (MCL); however, its utility is hampered by interobserver variability. The mantle cell international prognostic index (MIPI) has been reported to have prognostic importance. In this study, we determined the prognostic value of the PI as determined by quantitative image analysis in MCL. Patients and methods: Eighty-eight patients with adequate tissue were included in this analysis. Patients were treated with one of two treatment programs: sequential therapy with high-dose therapy consolidation or radioimmunotherapy followed by combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone. Patients were divided into four groups based on PI (<10%, 10%-29.9%, 30%-49.9%, and >50%), and outcomes were analyzed. Results: Thirty percent was identified as the optimal cut-off for PI. By univariate analysis, intensive treatment and a low PI were associated with a superior progression-free survival (PFS); only PI was associated with overall survival. By multivariate analysis, both intensive treatment and PI correlated with PFS. The MIPI had no prognostic impact. Conclusions: PI is the most important prognostic factor in MCL. The cut-off of 30% is clinically meaningful and can be used to tailor the intensity of therapy in future clinical trials.

Original languageEnglish (US)
Article numbermdp495
Pages (from-to)133-139
Number of pages7
JournalAnnals of Oncology
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Keywords

  • Mantle cell lymphoma
  • Prognosis
  • Proliferative index
  • Quantitative image analysis

ASJC Scopus subject areas

  • Hematology
  • Oncology

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