Progression of Disease within 24 Months (POD24) Based Prognostic Signature: A New Method for Personalized Risk Assessment in Patients with Mantle Cell Lymphoma

Background

Mantle cell lymphoma (MCL) is an uncommon lymphoproliferative disorder with extremely heterogeneous in both biological and clinical aspects. Its diverse clinical presentations necessitate a personalized prognostic model to stratify patients into subgroups with distinct survival outcomes.

Methods

Recognizing the limitations of existing models in capturing disease complexity, we utilized clinical and molecular data from nine Chinese medical centers to validate the progression of disease within 24 months (POD24) and to develop a novel prognostic risk model to predict the survival outcome of MCL patients.

Results

POD24 was observed in 37.7% of evaluable patients (369/979), with a significantly shorter median overall survival of 21 months compared to 122 months for those without POD24 (P < 0.0001).Patients with POD24 were more likely to present with B symptoms (P = 0.003), elevated lactate dehydrogenase (LDH) levels (P < 0.0001), splenomegaly (P < 0.0001), Ki-67 expression (P < 0.0001), and a poorer performance status (P = 0.005). Additionally, they were more likely to have undergone autologous stem cell transplantation (ASCT) (P = 0.037). The POD24-based risk model （POD24 ,age, LDH level, MIPI score, splenomegaly, Ki67 expression and ASCT）demonstrated the highest sensitivity for predicting survival, with an impressive area under the curve (AUC) for the risk score of 0.869.

Conclusion

Our study confirms the robust predictive power of POD24 and introduces a novel risk model that integrates POD24 with clinical factors. Our new prognostic model might be helpful to effectively classify MCL patients with high-risk groups in terms of survival rate, which may help select high-risk MCL patients for more intensive treatment at time of relapse. This novel developed model greatly improved the prognostic predictive accuracy, which could be used to individualize the survival outcomes of patients and has the potential translation into clinical practice in the future.

No relevant conflicts of interest to declare.