Complex karyotype is associated with aggressive disease and shortened progression-free survival in patients with newly diagnosed mantle cell lymphoma.

Cohen JB, Ruppert AS, Heerema NA, Andritsos LA, Jones JA, Porcu P, Baiocchi R, Christian BA, Byrd JC, Flynn J, Penza S, Devine SM, Blum KA
Clin Lymphoma Myeloma Leuk 15 278-285.e1 05/01/2015


BACKGROUND: Pretreatment cytogenetics are not routinely used to predict patient outcomes in mantle cell lymphoma (MCL). Based on the prognostic utility of cytogenetics in other diseases, we reviewed the effect of a complex karyotype (CK) in MCL.

PATIENTS AND METHODS: We included patients evaluated between November, 2002, and May, 2011. Those with ≥ 3 chromosomal abnormalities on a pre-treatment cytogenetic evaluation were defined as CK. Demographic, clinical, and survival differences between patients with CK and non-CK (NCK) were assessed.

RESULTS: Of 80 patients, 32 (40%) had CK, which was associated with high-risk clinical risk factors. Therapy did not differ between the groups, nor did rate of autologous stem cell transplant (ASCT). The 2-year progression-free survival (PFS) estimates were 70% and 48% for patients with NCK and CK, respectively (P = .02). Two-year overall survival (OS) estimates were also greater in those with NCK versus CK (85% vs. 58%; P = .02). When controlling for high-risk Mantle Cell Lymphoma International Prognostic Index (MIPI) score (P = .006), bulky disease (P = .01), and ASCT in first remission (P = .01), CK was not significantly associated with PFS (P = .18).

CONCLUSION: CK is associated with shortened PFS and OS in MCL but has not been demonstrated to be prognostic independent of other variables in this series.

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