The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT).
Mantle cell lymphoma (MCL) has a heterogeneous clinical course. The recently proposed Mantle Cell Lymphoma International Prognostic Index (MIPI) predicted the survival of MCL better than the International Prognostic Index in MCL patients treated with conventional chemotherapy, but its validity in MCL treated with more intensive immunochemotherapy has been questioned. Applied here to 158 patients of the Nordic MCL2 trial of first-line intensive immunochemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation, the MIPI and the simplified MIPI (s-MIPI) predicted survival significantly better (P < .001) than the International Prognostic Index (P > .004). Both the MIPI and the s-MIPI mainly identified 2 risk groups, low and intermediate versus high risk, with the more easily applied s-MIPI being just as powerful as the MIPI. The MIPI(B) (biological), incorporating Ki-67 expression, identified almost half of the patients as high risk. We suggest that also a simplified MIPI(B) is feasible.
Geisler
Christian H
CH
Department of Hematology, Rigshospitalet, Copenhagen, Denmark. christian.geisler@rh.regionh.dk
Kolstad
Arne
A
Laurell
Anna
A
Räty
Riikka
R
Jerkeman
Mats
M
Eriksson
Mikael
M
Nordström
Marie
M
Kimby
Eva
E
Boesen
Anne Marie
AM
Nilsson-Ehle
Herman
H
Kuittinen
Outi
O
Lauritzsen
Grete F
GF
Ralfkiaer
Elisabeth
E
Ehinger
Mats
M
Sundström
Christer
C
Delabie
Jan
J
Karjalainen-Lindsberg
Marja-Liisa
ML
Brown
Peter
P
Elonen
Erkki
E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects; D006801:Humans; D019394:Ki-67 Antigen / Q000096:biosynthesis; D020522:Lymphoma, Mantle-Cell / Q000378:metabolism / Q000401:mortality* / Q000628:therapy*; D008297:Male; D012307:Risk Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous
D019394:Ki-67 Antigen