title: Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival, independent of the MCL international prognostic index.
abstract: Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis.
authors.affiliation: Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, Université de Versailles-Saint Quentin, Versailles, France.
authors.forename: Clémentine
authors.initials: C
authors.lastname: Sarkozy
authors.forename: Christine
authors.initials: C
authors.lastname: Terré
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jardin
authors.forename: Isabelle
authors.initials: I
authors.lastname: Radford
authors.forename: Catherine
authors.initials: C
authors.lastname: Roche-Lestienne
authors.forename: Dominique
authors.initials: D
authors.lastname: Penther
authors.forename: Christian
authors.initials: C
authors.lastname: Bastard
authors.forename: Sophie
authors.initials: S
authors.lastname: Rigaudeau
authors.forename: Sylvain
authors.initials: S
authors.lastname: Pilorge
authors.forename: Franck
authors.initials: F
authors.lastname: Morschhauser
authors.forename: Didier
authors.initials: D
authors.lastname: Bouscary
authors.forename: Richard
authors.initials: R
authors.lastname: Delarue
authors.forename: Hassan
authors.initials: H
authors.lastname: Farhat
authors.forename: Philippe
authors.initials: P
authors.lastname: Rousselot
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.forename: Sylvie
authors.initials: S
authors.lastname: Castaigne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D002877:Chromosomes, Human / Q000235:genetics*; D005260:Female; D006801:Humans; D059785:Karyotype; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate