Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma

James N. Gerson; Elizabeth Handorf; Diego Villa; Alina S. Gerrie; Parv Chapani; Shaoying Li; L. Jeffrey Medeiros; Michael Wang; Jonathon B. Cohen; Michael Churnetski; Brian T. Hill; Yazeed Sawalha; Francisco J. Hernandez-Ilizaliturri; Shalin Kothari; Julie M. Vose; Martin Bast; Timothy Fenske; Swapna Narayana Rao Gari; Kami J. Maddocks; David Bond; Veronika Bachanova; Bhaskar Kolla; Julio Chavez; Bijal Shah; Frederick Lansigan; Timothy Burns; Alexandra M. Donovan; Nina Wagner-Johnston; Marcus Messmer; Amitkumar Mehta; Jennifer K. Anderson; Nishitha Reddy; Alexandra E. Kovach; Daniel J. Landsburg; Martha Glenn; David J. Inwards; Kay Ristow; Reem Karmali; Jason B. Kaplan; Paolo F. Caimi; Saurabh Rajguru; Andrew Evens; Andreas Klein; Elvira Umyarova; Bhargavi Pulluri; Jennifer E. Amengual; Jennifer K. Lue; Catherine Diefenbach; Richard I. Fisher; Stefan K. Barta

doi:10.1182/bloodadvances.2023010757

Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma

James N. Gerson, Elizabeth Handorf, Diego Villa, Alina S. Gerrie, Parv Chapani, Shaoying Li, L. Jeffrey Medeiros, Michael Wang, Jonathon B. Cohen, Michael Churnetski, Brian T. Hill, Yazeed Sawalha, Francisco J. Hernandez-Ilizaliturri, Shalin Kothari, Julie M. Vose, Martin Bast, Timothy Fenske, Swapna Narayana Rao Gari, Kami J. Maddocks, David BondVeronika Bachanova, Bhaskar Kolla, Julio Chavez, Bijal Shah, Frederick Lansigan, Timothy Burns, Alexandra M. Donovan, Nina Wagner-Johnston, Marcus Messmer, Amitkumar Mehta, Jennifer K. Anderson, Nishitha Reddy, Alexandra E. Kovach, Daniel J. Landsburg, Martha Glenn, David J. Inwards, Kay Ristow, Reem Karmali, Jason B. Kaplan, Paolo F. Caimi, Saurabh Rajguru, Andrew Evens, Andreas Klein, Elvira Umyarova, Bhargavi Pulluri, Jennifer E. Amengual, Jennifer K. Lue, Catherine Diefenbach, Richard I. Fisher, Stefan K. Barta

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Pages (from-to)	7393-7401
Number of pages	9
Journal	Blood Advances
Volume	7
Issue number	24
DOIs	https://doi.org/10.1182/bloodadvances.2023010757
State	Published - Dec 26 2023

Keywords

complete response to induction were associated with PFS; auto-HCT was not associated with OS
Patients with blastoid and pleomorphic variant MCL have suboptimal outcomes
Receipt of auto-HCT, MIPI score

ASJC Scopus subject areas

Hematology

Access to Document

10.1182/bloodadvances.2023010757

Cite this

Gerson, J. N., Handorf, E., Villa, D., Gerrie, A. S., Chapani, P., Li, S., Medeiros, L. J., Wang, M., Cohen, J. B., Churnetski, M., Hill, B. T., Sawalha, Y., Hernandez-Ilizaliturri, F. J., Kothari, S., Vose, J. M., Bast, M., Fenske, T., Gari, S. N. R., Maddocks, K. J., ... Barta, S. K. (2023). Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma. Blood Advances, 7(24), 7393-7401. https://doi.org/10.1182/bloodadvances.2023010757

Gerson, JN, Handorf, E, Villa, D, Gerrie, AS, Chapani, P, Li, S , Medeiros, LJ , Wang, M, Cohen, JB, Churnetski, M, Hill, BT, Sawalha, Y, Hernandez-Ilizaliturri, FJ, Kothari, S, Vose, JM, Bast, M, Fenske, T, Gari, SNR, Maddocks, KJ, Bond, D, Bachanova, V, Kolla, B, Chavez, J, Shah, B, Lansigan, F, Burns, T, Donovan, AM, Wagner-Johnston, N, Messmer, M, Mehta, A, Anderson, JK, Reddy, N, Kovach, AE, Landsburg, DJ, Glenn, M, Inwards, DJ, Ristow, K, Karmali, R, Kaplan, JB, Caimi, PF, Rajguru, S, Evens, A, Klein, A, Umyarova, E, Pulluri, B, Amengual, JE, Lue, JK, Diefenbach, C, Fisher, RI & Barta, SK 2023, 'Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma', Blood Advances, vol. 7, no. 24, pp. 7393-7401. https://doi.org/10.1182/bloodadvances.2023010757

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title = "Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma",

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.",

keywords = "complete response to induction were associated with PFS; auto-HCT was not associated with OS, Patients with blastoid and pleomorphic variant MCL have suboptimal outcomes, Receipt of auto-HCT, MIPI score",

author = "Gerson, {James N.} and Elizabeth Handorf and Diego Villa and Gerrie, {Alina S.} and Parv Chapani and Shaoying Li and Medeiros, {L. Jeffrey} and Michael Wang and Cohen, {Jonathon B.} and Michael Churnetski and Hill, {Brian T.} and Yazeed Sawalha and Hernandez-Ilizaliturri, {Francisco J.} and Shalin Kothari and Vose, {Julie M.} and Martin Bast and Timothy Fenske and Gari, {Swapna Narayana Rao} and Maddocks, {Kami J.} and David Bond and Veronika Bachanova and Bhaskar Kolla and Julio Chavez and Bijal Shah and Frederick Lansigan and Timothy Burns and Donovan, {Alexandra M.} and Nina Wagner-Johnston and Marcus Messmer and Amitkumar Mehta and Anderson, {Jennifer K.} and Nishitha Reddy and Kovach, {Alexandra E.} and Landsburg, {Daniel J.} and Martha Glenn and Inwards, {David J.} and Kay Ristow and Reem Karmali and Kaplan, {Jason B.} and Caimi, {Paolo F.} and Saurabh Rajguru and Andrew Evens and Andreas Klein and Elvira Umyarova and Bhargavi Pulluri and Amengual, {Jennifer E.} and Lue, {Jennifer K.} and Catherine Diefenbach and Fisher, {Richard I.} and Barta, {Stefan K.}",

year = "2023",

month = dec,

day = "26",

doi = "10.1182/bloodadvances.2023010757",

language = "English (US)",

volume = "7",

pages = "7393--7401",

journal = "Blood Advances",

issn = "2473-9529",

publisher = "American Society of Hematology",

number = "24",

}

TY - JOUR

T1 - Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma

AU - Gerson, James N.

AU - Handorf, Elizabeth

AU - Villa, Diego

AU - Gerrie, Alina S.

AU - Chapani, Parv

AU - Li, Shaoying

AU - Medeiros, L. Jeffrey

AU - Wang, Michael

AU - Cohen, Jonathon B.

AU - Churnetski, Michael

AU - Hill, Brian T.

AU - Sawalha, Yazeed

AU - Hernandez-Ilizaliturri, Francisco J.

AU - Kothari, Shalin

AU - Vose, Julie M.

AU - Bast, Martin

AU - Fenske, Timothy

AU - Gari, Swapna Narayana Rao

AU - Maddocks, Kami J.

AU - Bond, David

AU - Bachanova, Veronika

AU - Kolla, Bhaskar

AU - Chavez, Julio

AU - Shah, Bijal

AU - Lansigan, Frederick

AU - Burns, Timothy

AU - Donovan, Alexandra M.

AU - Wagner-Johnston, Nina

AU - Messmer, Marcus

AU - Mehta, Amitkumar

AU - Anderson, Jennifer K.

AU - Reddy, Nishitha

AU - Kovach, Alexandra E.

AU - Landsburg, Daniel J.

AU - Glenn, Martha

AU - Inwards, David J.

AU - Ristow, Kay

AU - Karmali, Reem

AU - Kaplan, Jason B.

AU - Caimi, Paolo F.

AU - Rajguru, Saurabh

AU - Evens, Andrew

AU - Klein, Andreas

AU - Umyarova, Elvira

AU - Pulluri, Bhargavi

AU - Amengual, Jennifer E.

AU - Lue, Jennifer K.

AU - Diefenbach, Catherine

AU - Fisher, Richard I.

AU - Barta, Stefan K.

PY - 2023/12/26

Y1 - 2023/12/26

N2 - 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.

AB - 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.

KW - complete response to induction were associated with PFS; auto-HCT was not associated with OS

KW - Patients with blastoid and pleomorphic variant MCL have suboptimal outcomes

KW - Receipt of auto-HCT, MIPI score

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U2 - 10.1182/bloodadvances.2023010757

DO - 10.1182/bloodadvances.2023010757

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AN - SCOPUS:85180954726

SN - 2473-9529

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EP - 7401

JO - Blood Advances

JF - Blood Advances

IS - 24

ER -

Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma

Abstract

Keywords

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