Original Article
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Blood Res 2014; 49(1):
Published online March 31, 2014
https://doi.org/10.5045/br.2014.49.1.15
© The Korean Society of Hematology
Clinical features and treatment outcomes in patients with mantle cell lymphoma in Korea: Study by the Consortium for Improving Survival of Lymphoma
1Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
2Department of Hematology/Oncology, Internal Medicine, Samsung Medical Center, Seoul, Korea.
3Department of Hematology/Oncology, Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
4Department of Hematology/Oncology, Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
5Department of Hematology/Oncology, Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
6Department of Hematology/Oncology, Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
7Department of Hematology/Oncology, Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
8Department of Hematology/Oncology, Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
9Department of Hematology/Oncology, Internal Medicine, Wonkwang University Hospital, Iksan, Korea.
10Department of Hematology/Oncology, Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea.
11Department of Hematology/Oncology, Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
12Department of Hematology/Oncology, Internal Medicine, Hallym University Scared Heart Hospital, Anyang, Korea.
13Department of Hematology/Oncology, Internal Medicine, Dong-A University Hospital, Busan, Korea.
14Department of Hematology/Oncology, Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
15Department of Hematology/Oncology, Internal Medicine, Asan Medical Center, Seoul, Korea.
Correspondence to : Correspondence to Cheolwon Suh, M.D., Ph.D., Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3209, Fax: +82-2-3010-6961, csuh@amc.seoul.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background
We investigated the clinical features and treatment outcomes of patients with mantle cell lymphoma (MCL) in Korea.
Methods
We retrospectively analyzed the clinical characteristics and prognosis of 131 patients diagnosed with MCL between January 2004 and December 2009 at 15 medical centers in Korea; all patients received at least 1 chemotherapeutic regimen for MCL.
Results
The median age for the patients was 63 years (range, 26-78 years), and 77.9% were men. A total of 105 patients (80.1%) had stage III or IV MCL at diagnosis. Fifty-two patients (39.7%) were categorized with high- or high-intermediate risk MCL according to the International Prognostic Index (IPI). Eighteen patients (13.7%) were in the high-risk group according to the simplified MCL-IPI (MIPI). The overall incidence of extranodal involvement was 69.5%. The overall incidence of bone marrow and gastrointestinal involvements at diagnosis was 41.2% and 35.1%, respectively. Cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab were used frequently as the first-line treatment (41.2%). With a median follow-up duration of 20.0 months (range, 0.2-77.0 months), the overall survival (OS) at 2 years was 64.7%, while the event-free survival (EFS) was 39.7%. Multivariate analysis showed that the simplified MIPI was significantly associated with OS. However, the use of a rituximab-containing regimen was not associated with OS and EFS.
Conclusion
Similar to results from Western countries, the current study found that simplified MIPI was an important prognostic factor in Korean patients with MCL.
Keywords Mantle cell lymphoma, Epidemiology, Trend, Survival, Chemotherapy, Rituximab
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Original Article
Blood Res 2014; 49(1): 15-21
Published online March 31, 2014 https://doi.org/10.5045/br.2014.49.1.15
Copyright © The Korean Society of Hematology.
Clinical features and treatment outcomes in patients with mantle cell lymphoma in Korea: Study by the Consortium for Improving Survival of Lymphoma
Byung Woog Kang1, Sang Kyun Sohn1,#*, Joon Ho Moon1, Yee Soo Chae1, Jong Gwang Kim1, Soo Jung Lee1, Won Seog Kim2, Je-Jung Lee3, Se Ryeon Lee4, Keon Uk Park5, Ho Sup Lee6, Won Sik Lee7, Jong-Ho Won8, Moo-Rim Park9, Jae-Yong Kwak10, Min Kyoung Kim11, Hyo Jung Kim12, Sung Yong Oh13, Hye Jin Kang14, and Cheolwon Suh15,#*
1Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
2Department of Hematology/Oncology, Internal Medicine, Samsung Medical Center, Seoul, Korea.
3Department of Hematology/Oncology, Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
4Department of Hematology/Oncology, Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
5Department of Hematology/Oncology, Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
6Department of Hematology/Oncology, Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
7Department of Hematology/Oncology, Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
8Department of Hematology/Oncology, Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
9Department of Hematology/Oncology, Internal Medicine, Wonkwang University Hospital, Iksan, Korea.
10Department of Hematology/Oncology, Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea.
11Department of Hematology/Oncology, Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
12Department of Hematology/Oncology, Internal Medicine, Hallym University Scared Heart Hospital, Anyang, Korea.
13Department of Hematology/Oncology, Internal Medicine, Dong-A University Hospital, Busan, Korea.
14Department of Hematology/Oncology, Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
15Department of Hematology/Oncology, Internal Medicine, Asan Medical Center, Seoul, Korea.
Correspondence to:Correspondence to Cheolwon Suh, M.D., Ph.D., Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3209, Fax: +82-2-3010-6961, csuh@amc.seoul.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
We investigated the clinical features and treatment outcomes of patients with mantle cell lymphoma (MCL) in Korea.
Methods
We retrospectively analyzed the clinical characteristics and prognosis of 131 patients diagnosed with MCL between January 2004 and December 2009 at 15 medical centers in Korea; all patients received at least 1 chemotherapeutic regimen for MCL.
Results
The median age for the patients was 63 years (range, 26-78 years), and 77.9% were men. A total of 105 patients (80.1%) had stage III or IV MCL at diagnosis. Fifty-two patients (39.7%) were categorized with high- or high-intermediate risk MCL according to the International Prognostic Index (IPI). Eighteen patients (13.7%) were in the high-risk group according to the simplified MCL-IPI (MIPI). The overall incidence of extranodal involvement was 69.5%. The overall incidence of bone marrow and gastrointestinal involvements at diagnosis was 41.2% and 35.1%, respectively. Cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab were used frequently as the first-line treatment (41.2%). With a median follow-up duration of 20.0 months (range, 0.2-77.0 months), the overall survival (OS) at 2 years was 64.7%, while the event-free survival (EFS) was 39.7%. Multivariate analysis showed that the simplified MIPI was significantly associated with OS. However, the use of a rituximab-containing regimen was not associated with OS and EFS.
Conclusion
Similar to results from Western countries, the current study found that simplified MIPI was an important prognostic factor in Korean patients with MCL.
Keywords: Mantle cell lymphoma, Epidemiology, Trend, Survival, Chemotherapy, Rituximab
Fig 1.
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Kaplan-Meier analysis of overall survival and event-free survival.
Fig 2.
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Kaplan-Meier analysis of (
Fig 3.
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Kaplan-Meier analysis of (
Fig 4.
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Kaplan-Meier analysis of (
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Table 1 . Baseline characteristics of patients..
Values are presented as numbers (%)..
Abbreviations: ECOG, Eastern Cooperation Oncology Group; IPI, International Prognostic Index; MIPI, MCL International Prognostic Index; BM, bone marrow; CNS, central nervous system; GI, gastrointestinal tract..
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Table 2 . Types of first-line treatment..
Values are presented as numbers (%)..
Abbreviations: R-CHOP, rituximab, cyclophosphamide, doxorubicin, and prednisone; RHyperCVAD/RMTX-Ara-C, rituximab, doxorubicin, vincristine, dexamethasone, methotrexate, and cytarabine; RCVP, rituximab, cyclophosphamide, vincristine, and prednisone; RICE, rituximab, ifosfamide, carboplatin, and etoposide; RESHAP, rituximab, etoposide, methylprednisone, cytarabine, and cisplatin; CHOP, cyclophosphamide, doxorubicin, and prednisone; HyperCVAD/MTX-Ara-C, doxorubicin, vincristine, dexamethasone, methotrexate, and cytarabine; CVP, cyclophosphamide, vincristine, and prednisone; ICE, ifosfamide, carboplatin, and etoposide; ESHAP, etoposide, methylprednisone, cytarabine, and cisplatin; GIDOX, gemcitabine, ifosfamide, dexamethasone, and oxaliplatin..
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Table 3 . Treatment outcomes of patients..
Values are presented as numbers (%)..
Abbreviations: CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; CHOP, cyclophosphamide, doxorubicin, and prednisone; CVP, cyclophosphamide, vincristine, and prednisone; ICE, ifosfamide, carboplatin, and etoposide..
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Table 4 . Univariate and multivariate analyses for factors affecting EFS and OS..
a)Log-rank test for univariate analysis..
Abbreviations: HR, hazard ratio; MIPI, MCL International Prognostic Index; EFS, event-free survival; OS, overall survival; CI, confidence interval..
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