Prognostic Analysis Of 23 Patients With Recurrent Or Refractory Mantle Cell Lymphoma

Objective:To analyze clinicopathological features and prognostic factors of relapsed or refractory mantle cell lymphoma(R/RMCL)over the past 2years retrospectively.Methods:A total of 23 cases of diagnosed with relapsed or refractory MCL at Affiliated Hospital of Qing Dao University between April 2014 to January 2017 were enrolled.The clinicopathological features were summarized such as age gender Ann-Arbor stage Ki 67 MIPI etc.Prognostic analysis were conducted on the clinicopathological features and the second-line treatment protocols of these patients.Results: 1.Among the 23 relapsed and refractory MCL patients,the median age was 65 years old(46—77 years).The ratio of male to female was 3.61:1.There were 20cases(87.0%)presented with Ann Arbor stage III—IV and 17 cases(73.9%)with extranodal involvement.According to Mantle cell lymphoma International Prognostic Index(MIPI),10patients(43.5%)were classified as low risk,19patients(39.1%)as intermediate risk and 4 patients(17.4%)as high risk.2.15 patients were treated with RC/RCC protocol other 8 patients treated by R-DHAP.The objective response rate(ORR)of patients treated with RC/RCC was significantly superior than those with R-DHAP.(P =0.042)3.3 Ki-67,MIPI prognostic score,MIPI-b prognostic score and first line treatment showed prognostic relevance for PFS(P<0.05).MIPI prognostic score,MIPI-b prognostic score and second line treatment showed prognostic relevance for OS(P<0.05).Conclusion: 1.MCL is mostly common in elderly male.The majority of patients presents with stage III—IV and extranodal involvement at diagnosis.Refused and refractory are common.2.MIPI and MIPI-b is a helpful prognostic classification tool and Ki-67 is a biological prognostic factor for R/R MCL.Induction therapy including Rituximab and cytarabine can lead to better response and prolonged survival with acceptable adverse effect.