Background The heterogeneity of the clinical course, biology and genomics manifestations has observed in MCL patient. The unified consensus information on high-risk MCL definition is sparse and unclear. A more refined risk stratification are imperative needed for MCL patients. In our study, we aimed to define the generalized high-risk group who had more than one factors including MIPI, aggressive pathological features, TP53 alterations and complex karyotypes.

Methods This retrospective study analyzed data for adult patients diagnosed with MCL from January 2000 to October 2022 at 19 comprehensive hospitals in China with the total of 1017 patients. 861 patients with complete medical records and follow-up data were included in the analysis. Among of them,150 patients belonged to the narrow definition of high-risk group by MIPI score, 284 patients were the generalized high-risk group by comprehensive factors(Figure 1).

Result According to the narrow definition of high-risk stratification, the median PFS was 46.0 and 21.0 months, and the 5-year PFS was 39.3% and 15.6% in low-risk group(n=659) and high-risk group(n=150), respectively. The median OS was 106 and 47.0 months, the 5-year OS was 72.3% and 46.1%((all p<0.05). According to generalized high-risk stratification, the median PFS was 51.0 and 23.0 months in the low-risk group (n=562) and high-risk group(n=283), and the 5-year PFS was 42.8% and 17.9%, respectively. The median OS was 118.0 and 57.0 months, with the 5-year OS of 78.3 % and 49.2%, respectively (all p<0.05, Figure 2). Furtherly, prognostic analysis in the generalized high-risk grouprevealed that high-risk group according to MIPI score and patients with TP53 alterations were independent prognostic factors for PFS.TP53 alterations combined with other high-risk genes, elevated β-2 microglobulin levels, and the presence of B symptoms were independent prognostic factors for OS in this study.

Conclusions Our study indicated that the generalized high-risk group that integrated the clinical, pathological, and molecular biological features had a good predictive value in the prognosis of MCL. It is a simple and feasible method to distinguish high-risk mantle cell lymphoma and provide better treatment decisions for clinical practice.

Disclosures

No relevant conflicts of interest to declare.

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2024
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