title: Clinicopathologic features, management and outcomes of blastoid variant of mantle cell lymphoma: a Nebraska Lymphoma Study Group Experience.
abstract: The objective of this retrospective study (N = 169) was to compare the overall survival (OS) of different subtypes of mantle cell lymphoma (MCL) treated by the Nebraska Lymphoma Study Group between 1984 and 2012. The overall response rate to various therapies including stem cell transplant (SCT) was similar (p = 0.44) between blastoid, diffuse and nodular subtypes. At 5 years, blastoid and diffuse subtypes had worse OS (overall p = 0.005) compared to nodular subtype. In multivariate analysis, the blastoid and diffuse subtypes had similar risk of death (p = 0.14) whereas the nodular subtype had a lower risk compared to blastoid (HR 0.48, 95% CI 0.27-0.87, p = 0.01). The use of SCT was associated with lower risk of death. In univariate analysis, blastoid subtype had better OS with intensive upfront therapy. In conclusion, the OS of blastoid subtype is worse than nodular MCL but may improve with the use of SCT and probably intensive induction therapy.
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: Vijaya R
authors.initials: VR
authors.lastname: Bhatt
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: Fausto R
authors.initials: FR
authors.lastname: Loberiza
authors.affiliation: b Department of Biostatistics College of Public Health , University of Nebraska Medical Center , Omaha , NE , USA , and.
authors.forename: Lynette M
authors.initials: LM
authors.lastname: Smith
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: James O
authors.initials: JO
authors.lastname: Armitage
authors.affiliation: c Department of Pathology and Microbiology , University of Nebraska Medical Center , Omaha , NE , USA.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Greiner
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: Martin
authors.initials: M
authors.lastname: Bast
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Lunning
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Bierman
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.affiliation: a Department of Internal Medicine, Division of Hematology-Oncology , University of Nebraska Medical Center , Omaha , NE , USA .
authors.forename: R Gregory
authors.initials: RG
authors.lastname: Bociek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000378:metabolism* / Q000473:pathology*; D003131:Combined Modality Therapy; D019468:Disease Management; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Blastoid variant; diffuse subtype; intensive induction therapy; mantle cell lymphoma; nodular subtype; stem cell transplantation