The Mantle Cell Lymphoma International Prognostic Index (MIPI) is superior to the International Prognostic Index (IPI) in predicting survival following intensive first-line immunochemotherapy and autologous stem cell transplantation (ASCT)

• Published in: Blood 2010-02, Vol.115 (8), p.1530-1533
• Main Authors: Geisler, Christian H., Kolstad, Arne, Laurell, Anna, Räty, Riikka, Jerkeman, Mats, Eriksson, Mikael, Nordström, Marie, Kimby, Eva, Boesen, Anne Marie, Nilsson-Ehle, Herman, Kuittinen, Outi, Lauritzsen, Grete F., Ralfkiær, Elisabeth, Ehinger, Mats, Sundström, Christer, Delabie, Jan, Karjalainen-Lindsberg, Marja-Liisa, Brown, Peter, Elonen, Erkki, for the Nordic Lymphoma Group
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Biological and medical sciences; Clinical Medicine; Dermatologi och venerologi, klinisk genetik, invärtesmedicin; Dermatology and venerology,clinical genetics, internal medicine; Disease-Free Survival; Female; Gene Expression Regulation, Neoplastic - drug effects; Haematology; Hematologi; Hematologic and hematopoietic diseases; Hematology; Humans; Internal medicine; Invärtesmedicin; Ki-67 Antigen - biosynthesis; Klinisk medicin; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Mantle-Cell - metabolism; Lymphoma, Mantle-Cell - mortality; Lymphoma, Mantle-Cell - therapy; Male; Mantle Cell Lymphoma; Medical and Health Sciences; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Morfologi, cellbiologi, patologi; Morphology, cell biology, pathology; Pathology; Patologi; Risk Factors; Stem Cell Transplantation; Survival Rate; Transplantation, Autologous
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood-2009-08-236570

Mantle cell lymphoma (MCL) has a heterogeneous clinical course. The recently proposed Mantle Cell Lymphoma International Prognostic Index (MIPI) predicted the survival of MCL better than the International Prognostic Index in MCL patients treated with conventional chemotherapy, but its validity in MCL treated with more intensive immunochemotherapy has been questioned. Applied here to 158 patients of the Nordic MCL2 trial of first-line intensive immunochemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation, the MIPI and the simplified MIPI (s-MIPI) predicted survival significantly better (P < .001) than the International Prognostic Index (P > .004). Both the MIPI and the s-MIPI mainly identified 2 risk groups, low and intermediate versus high risk, with the more easily applied s-MIPI being just as powerful as the MIPI. The MIPIB (biological), incorporating Ki-67 expression, identified almost half of the patients as high risk. We suggest that also a simplified MIPIB is feasible. This trial was registered at www.isrctn.org as #ISRCTN 87866680.