Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma

• Type of Material: Article
• Authors: James N Gerson, University of Pennsylvania; Elizabeth Handorf, Fox Chase Cancer Center, Philadelphia; Diego Villa, 3BC Cancer Centre for Lymphoid Cancer, Vancouver; Alina S Gerrie, 3BC Cancer Centre for Lymphoid Cancer, Vancouver; Parv Chapani, 3BC Cancer Centre for Lymphoid Cancer, Vancouver; Jonathan B Cohen, Emory University; Michael Churnetski, Emory University; Brian T Hill, Cleveland Clinic Foundation; Yazeed Sawalha, Cleveland Clinic Foundation; Francisco J Hernandez-Ilizaliturri, Roswell Park Cancer Institute, Buffalo; Shalin Kothari, Roswell Park Cancer Institute, Buffalo; Julie M Vose, University of Nebraska Cancer Center, Omaha; Martin Bast, University of Nebraska Cancer Center, Omaha; Timothy Fenske, Medical College of Wisconsin; Swapna Narayana Rao Gari, Medical College of Wisconsin; Kami J Maddocks, Ohio State University; David Bond, Ohio State University; Veronika Bachanova, University of Minnesota; Bhaskar Kolla, University of Minnesota; Julio Chavez, Moffitt Cancer Center, Tampa; Bijal Shah, Moffitt Cancer Center, Tampa; Frederick Lansigan, Dartmouth-Hitchcock Medical Center, Lebanon; Timothy Burns, Dartmouth-Hitchcock Medical Center, Lebanon; Alexandra M Donovan, Dartmouth-Hitchcock Medical Center, Lebanon; Nina Wagner-Johnston, Johns Hopkins University; Marcus Messmer, Johns Hopkins University; Amitkumar Mehta, University of Alabama Cancer Center; Jennifer K Anderson, University of Alabama Cancer Center; Nishitha Reddy, Vanderbilt Ingram Cancer Center; Alexandra E Kovach, Vanderbilt Ingram Cancer Center; Daniel J Landsburg, University of Pennsylvania; Martha Glenn, Huntsman Cancer Institute, Salt Lake City; David J Inwards, Mayo Clinic, Rochester; Kay Ristow, Mayo Clinic, Rochester; Reem Karmali, Northwestern University; Jason B Kaplan, Northwestern University; Paolo F Caimi, Case Western Reserve University, Cleveland; Saurabh Rajguru, University of Wisconsin; Andrew Evens, Tufts University; Andreas Klein, Tufts University; Elvira Umyarova, University of Vermont; Bhargavi Pulluri, University of Vermont; Jennifer E Amengual, Columbia University; Jennifer K Lue, Columbia University; Catherine Diefenbach, New York University; Richard I Fisher, Fox Chase Cancer Center, Philadelphia; Stefan K Barta, University of Pennsylvania
• Language: English
• Date: 2023-12-26
• Publisher: American Society of Hematology (ASH)
• Publication Version: Final Published Version
• Copyright Statement: © 2023 by The American Society of Hematology
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://ashpublications.org/bloodadvances/article/7/24/7393/498405/Outcomes-of-patients-with-blastoid-and-pleomorphic
• Title of Journal or Parent Work: Blood Advances
• Volume: 7
• Issue: 24
• Start Page: 7393
• End Page: 7401
• Keywords: Pleomorphic variant; Blastoid variant; Hematopoietic cell transplantation; Prognostic factors; Mantle cell lymphoma
• Research Categories: Health Sciences, Oncology; Health Sciences, Medicine and Surgery; Health Sciences, General

Abstract

Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma; data indicate that blastoid and pleomorphic variants have a poor prognosis. We report characteristics and outcomes of patients with blastoid/pleomorphic variants of MCL. We retrospectively studied adults with newly diagnosed MCL treated from 2000 to 2015. Primary objectives were to describe progression-free survival (PFS) and overall survival (OS). Secondary objectives included characterization of patient characteristics and treatments. Of the 1029 patients with MCL studied, a total of 207 neoplasms were blastoid or pleomorphic variants. Median follow-up period was 82 months (range, 0.1-174 months); median PFS was 38 months (95% confidence interval [CI], 28-66) and OS was 68 months (95% CI, 45-96). Factors associated with PFS were receipt of consolidative autologous hematopoietic transplantation (auto-HCT; hazard ratio [HR], 0.52; 95% CI, 0.31-0.80; P < .05), MCL International Prognostic Index (MIPI) intermediate (HR, 2.3; 95% CI, 1.2-4.3; P < .02) and high (HR, 3.8; 95% CI, 2.0-7.4; P < .01) scores, and complete response to induction (HR, 0.29 (95% CI, 0.17-0.51). Receipt of auto-HCT was not associated with OS (HR, 0.69; 95% CI, 0.41-1.16; P = .16) but was associated with MIPI intermediate (HR, 5.7; 95% CI, 2.5-13.2; P < .01) and high (HR, 10.8; 95% CI, 4.7-24.9; P < .01) scores. We report outcomes in a large cohort of patients with blastoid/pleomorphic variant MCL. For eligible patients, receipt of auto-HCT after induction was associated with improved PFS but not OS. Higher MIPI score and auto-HCT ineligibility were associated with worse survival.