Cohen Jonathon B, Ruppert Amy S, Heerema Nyla A, Andritsos Leslie A, Jones Jeffrey A, Porcu Pierluigi, Baiocchi Robert, Christian Beth A, Byrd John C, Flynn Joseph, Penza Sam, Devine Steven M, Blum Kristie A
Division of Hematology, The Ohio State University-James Comprehensive Cancer Center, Columbus, OH.
Division of Hematology, The Ohio State University-James Comprehensive Cancer Center, Columbus, OH.
Clin Lymphoma Myeloma Leuk. 2015 May;15(5):278-285.e1. doi: 10.1016/j.clml.2014.12.012. Epub 2014 Dec 31.
Pretreatment cytogenetics are not routinely used to predict patient outcomes in mantle cell lymphoma (MCL). Based on the prognostic utility of cytogenetics in other diseases, we reviewed the effect of a complex karyotype (CK) in MCL.
We included patients evaluated between November, 2002, and May, 2011. Those with ≥ 3 chromosomal abnormalities on a pre-treatment cytogenetic evaluation were defined as CK. Demographic, clinical, and survival differences between patients with CK and non-CK (NCK) were assessed.
Of 80 patients, 32 (40%) had CK, which was associated with high-risk clinical risk factors. Therapy did not differ between the groups, nor did rate of autologous stem cell transplant (ASCT). The 2-year progression-free survival (PFS) estimates were 70% and 48% for patients with NCK and CK, respectively (P = .02). Two-year overall survival (OS) estimates were also greater in those with NCK versus CK (85% vs. 58%; P = .02). When controlling for high-risk Mantle Cell Lymphoma International Prognostic Index (MIPI) score (P = .006), bulky disease (P = .01), and ASCT in first remission (P = .01), CK was not significantly associated with PFS (P = .18).
CK is associated with shortened PFS and OS in MCL but has not been demonstrated to be prognostic independent of other variables in this series.
预处理细胞遗传学检查在套细胞淋巴瘤（MCL）中并非常规用于预测患者预后。基于细胞遗传学在其他疾病中的预后价值，我们回顾了复杂核型（CK）在MCL中的作用。
我们纳入了2002年11月至2011年5月期间接受评估的患者。预处理细胞遗传学评估显示有≥3条染色体异常的患者被定义为CK。评估了CK患者与非CK（NCK）患者在人口统计学、临床特征及生存方面的差异。
80例患者中，32例（40%）有CK，这与高风险临床危险因素相关。两组间治疗方法及自体干细胞移植（ASCT）率无差异。NCK患者和CK患者的2年无进展生存期（PFS）估计分别为70%和48%（P = 0.
02）。NCK患者的2年总生存期（OS）估计也高于CK患者（85%对vs. 58%；P = 0.02）。在控制高风险套细胞淋巴瘤国际预后指数（MIPI）评分（P = 0.006）、大包块疾病（P = 0.01）及首次缓解时进行ASCT（P = 0.01）后，CK与PFS无显著相关性（P = 0.18）。
CK与MCL患者PFS和OS缩短相关，但在本系列研究中尚未证明其独立于其他变量具有预后价值。
