Yang Yuan, Yang Ping, Zhang Wei, Liu Hui, Sun Xiuhua, Xiao Xiubin, Wang Jingwen, Li Zhenling, Li Lihong, Wang Shuye, He Juan, Li Xiaoling, Cai Qingqing, Zhang Weilong, Wang Jing, Li Chunyuan, Chen Yingtong, Liu Shuozi, Jing Hongmei
Department of Hematology, Peking University Third Hospital, Beijing, China.
Department of Hematology, Peking Union Medical College Hospital, Beijing, China.
Ann Med. 2025 Dec;57(1):2482013. doi: 10.1080/07853890.2025.2482013. Epub 2025 Mar 27.
Mantle cell lymphoma (MCL), an uncommon lymphoma subtype, is clinically characterized by its heterogenous behavior. Established prediction system including several clinical and biological parameters can help in determining the aggressiveness of MCL in younger patients. However, there are limited parameters on predicting the clinical outcome of older patients. The present study was performed to identify the prognostic factors and optimal treatment modalities in older Chinese MCL patients.
Patients (age ≥ 65 yrs) with MCL from 19 comprehensive hospitals in China were included. Clinical characteristics, therapeutic strategies, progression-free survival (PFS) and overall survival (OS) time of these patients were collected.
Totally, 259 eligible patients were enrolled. The median age of patients was 69 years (range, 65-88). The median of PFS and OS were 29 months (95%CI: 26-37) and 76 months (95%CI: 61-96) months, respectively. Multivariate regression analysis determined that ECOG score ≥ 2, high MIPI score and absence of maintenance treatment were independently associated with poorer PFS of MCL patients; while ECOG score ≥ 2 and absence of maintenance treatment were independently correlated with a poorer OS. Patients with MCL who received BTKi-containing regimens or maintenance therapy showed significantly longer PFS and OS than those who did not receive these therapies. Maintenance treatment can improve the survival rate of older patients with MCL regardless of TP53 status.
ECOG ≥ 2, high MIPI score, and absence of maintenance therapy were associated with poorer survival outcomes for older Chinese MCL patients. Maintenance therapy and BTKi-containing regimens have been shown to increase the survival rate of older Chinese MCL patients.
套细胞淋巴瘤（MCL）是一种罕见的淋巴瘤亚型，临床行为具有异质性。包括若干临床和生物学参数的既定预测系统有助于确定年轻患者MCL的侵袭性。然而，预测老年患者临床结局的参数有限。本研究旨在确定中国老年MCL患者的预后因素和最佳治疗方式。
纳入来自中国19家综合医院的MCL患者（年龄≥65岁）。收集这些患者的临床特征、治疗策略、无进展生存期（PFS）和总生存期（OS）。
共纳入259例符合条件的患者。患者的中位年龄为69岁（范围65 - 88岁）。PFS和OS的中位数分别为29个月（95%CI：26 - 37）和76个月（95%CI：61 - 96）。多因素回归分析确定，ECOG评分≥2、高MIPI评分和未进行维持治疗与MCL患者较差的PFS独立相关；而ECOG评分≥2和未进行维持治疗与较差的OS独立相关。接受含BTKi方案或维持治疗的MCL患者的PFS和OS显著长于未接受这些治疗的患者。无论TP53状态如何，维持治疗均可提高老年MCL患者生存率。
ECOG≥2、高MIPI评分和未进行维持治疗与中国老年MCL患者较差的生存结局相关。维持治疗和含BTKi方案已被证明可提高中国老年MCL患者的生存率。
