Prognostic impact of proliferative index determined by quantitative image analysis and the international prognostic index in patients with mantle cell lymphoma Journal Article


Authors: Schaffel, R.; Hedvat, C.; Teruya-Feldstein, J.; Persky, D.; Maragulia, J.; Lin, D.; Portlock, C. S.; Moskowitz, C. H.; Zelenetz, A. D.
Article Title: Prognostic impact of proliferative index determined by quantitative image analysis and the international prognostic index in patients with mantle cell lymphoma
Abstract: Background: The proliferative index (PI) is a powerful prognostic factor in mantle cell lymphoma (MCL); however, its utility is hampered by interobserver variability. The mantle cell international prognostic index (MIPI) has been reported to have prognostic importance. In this study, we determined the prognostic value of the PI as determined by quantitative image analysis in MCL. Patients and methods: Eighty-eight patients with adequate tissue were included in this analysis. Patients were treated with one of two treatment programs: sequential therapy with high-dose therapy consolidation or radioimmunotherapy followed by combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone. Patients were divided into four groups based on PI (<10%, 10%-29.9%, 30%-49.9%, and >50%), and outcomes were analyzed. Results: Thirty percent was identified as the optimal cut-off for PI. By univariate analysis, intensive treatment and a low PI were associated with a superior progression-free survival (PFS); only PI was associated with overall survival. By multivariate analysis, both intensive treatment and PI correlated with PFS. The MIPI had no prognostic impact. Conclusions: PI is the most important prognostic factor in MCL. The cut-off of 30% is clinically meaningful and can be used to tailor the intensity of therapy in future clinical trials. © The Author 2009. Published by Oxford University Press [on behalf of the European Society for Medical Oncology].
Keywords: immunohistochemistry; adult; controlled study; human tissue; aged; disease-free survival; middle aged; major clinical study; overall survival; prednisone; mortality; doxorubicin; disease free survival; cytarabine; rituximab; methodology; antineoplastic agent; ki 67 antigen; cell proliferation; ki-67 antigen; carboplatin; progression free survival; mantle cell lymphoma; multiple cycle treatment; image analysis; etoposide; antineoplastic combined chemotherapy protocols; tumor markers, biological; cyclophosphamide; melphalan; vincristine; stem cell transplantation; drug effect; pathology; tumor marker; carmustine; ifosfamide; kaplan-meiers estimate; kaplan meier method; image processing, computer-assisted; image processing; tositumomab i 131; lymphoma, mantle-cell; international prognostic index; proliferative index; quantitative image analysis; named inventories, questionnaires and rating scales
Journal Title: Annals of Oncology
Volume: 21
Issue: 1
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2010-01-01
Start Page: 133
End Page: 139
Language: English
DOI: 10.1093/annonc/mdp495
PUBMED: 20019090
PROVIDER: scopus
PMCID: PMC2795614
DOI/URL:
Notes: --- - "Cited By (since 1996): 4" - "Export Date: 20 April 2011" - "Art. No.: mdp495" - "CODEN: ANONE" - "Source: Scopus"
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MSK Authors
  1. Daniel Oscar Persky
    10 Persky
  2. Carol Portlock
    204 Portlock
  3. Craig Moskowitz
    407 Moskowitz
  4. Cyrus Hedvat
    126 Hedvat
  5. Julie T Feldstein
    297 Feldstein
  6. Andrew D Zelenetz
    767 Zelenetz
  7. Jocelyn C Migliacci
    104 Migliacci
  8. Dorothy S Lin
    4 Lin