title: Ki-67 predicts outcome in advanced-stage mantle cell lymphoma patients treated with anti-CD20 immunochemotherapy: results from randomized trials of the European MCL Network and the German Low Grade Lymphoma Study Group.
abstract: 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.
authors: Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors: Olaf
authors: O
authors: Determann
authors: Eva
authors: E
authors: Hoster
authors: German
authors: G
authors: Ott
authors: Heinz
authors: H
authors: Wolfram Bernd
authors: Christoph
authors: C
authors: Loddenkemper
authors: Martin
authors: M
authors: Leo Hansmann
authors: Thomas E F
authors: TE
authors: Barth
authors: Michael
authors: M
authors: Unterhalt
authors: Wolfgang
authors: W
authors: Hiddemann
authors: Martin
authors: M
authors: Dreyling
authors: Wolfram
authors: W
authors: Klapper
mesh_terms: D018951:Antigens, CD20 / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D005060:Europe; D005858:Germany; D006801:Humans; D007167:Immunotherapy; D019394:Ki-67 Antigen / Q000097:blood*; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy* / Q000473:pathology; D015337:Multicenter Studies as Topic; D009367:Neoplasm Staging; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D018951:Antigens, CD20; D015415:Biomarkers; D019394:Ki-67 Antigen