Determann Olaf, Hoster Eva, Ott German, Wolfram Bernd Heinz, Loddenkemper Christoph, Leo Hansmann Martin, Barth Thomas E F, Unterhalt Michael, Hiddemann Wolfgang, Dreyling Martin, Klapper Wolfram
Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Blood. 2008 Feb 15;111(4):2385-7. doi: 10.1182/blood-2007-10-117010. Epub 2007 Dec 12.
Clinical outcome of mantle cell lymphoma (MCL) is highly heterogeneous. Tumor cell proliferation as assessed by the Ki-67 index has been shown to yield prognostic information on MCL in many studies using heterogeneously treated patient cohorts. The prognostic value of the Ki-67 index in patients treated with anti-CD20 therapy has not been studied so far. We analyzed the Ki-67 index at primary diagnosis in 249 advanced-stage MCL patients treated within randomized trials. Ki-67 showed high prognostic relevance for overall survival (relative risk 1.27 for 10% higher Ki-67, P < .001), also independently from clinical prognostic factors. The 3 groups with different Ki-67 index of less than 10%, 10% to less than 30%, and 30% or more showed significantly different overall survival in patients treated with CHOP (P = .001) as well as in patients treated with CHOP in combination with anti-CD20 therapy (R-CHOP, P = .013). Thus, the Ki-67 index remains an important prognostic marker in the era of anti-CD20 therapy. The Euro-pean MCL study is registered at www.ClinicalTrials.gov as #NCT00016887.
套细胞淋巴瘤（MCL）的临床结局具有高度异质性。在许多使用异质性治疗患者队列的研究中，通过Ki-67指数评估的肿瘤细胞增殖已显示出可提供有关MCL的预后信息。迄今为止，尚未研究Ki-67指数在接受抗CD20治疗患者中的预后价值。我们分析了在随机试验中接受治疗的249例晚期MCL患者初诊时的Ki-67指数。Ki-67对总生存期显示出高度的预后相关性（Ki-67每高10%，相对风险为1.27，P <.001），且独立于临床预后因素。Ki-67指数分别低于10%、10%至低于30%以及30%及以上的三组患者，在接受CHOP治疗的患者中（P =.001）以及在接受CHOP联合抗CD20治疗（R-CHOP）的患者中（P =.013），总生存期均存在显著差异。因此，在抗CD20治疗时代，Ki-67指数仍然是一个重要的预后标志物。欧洲MCL研究已在www.ClinicalTrials.gov上注册，注册号为#NCT00016887。
