Abstract 800

Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma (NHL) accounting for ~6% of all NHL. It is sensitive to combination chemotherapy, but remission durations are short without approaches such as stem cell transplantation (SCT). Most patients are incurable, but the clinical course is variable, with some patients succumbing quickly, while others survive >10 years. MicroRNAs (miRs) are small, non-coding RNAs that regulate gene expression by inhibiting mRNA translation. miRs are useful in the prognostic assessment of tumors, but work to date examining differences between MCL and normal lymphoid tissues, have only identified 2 miRs involved in MCL prognosis (Zhao JJ, Blood, 2010; Di Lisio L, Leukemia, 2010). We used a novel approach to identify a prognostic miR signature in MCL. We hypothesized that a miR signature defining aggressiveness can be obtained by comparing miR expression profiles of aggressive NHL with indolent NHL, and that this signature when applied to a set of MCL cases, may aid in MCL prognosis. Total RNA was extracted from 135 formalin-fixed paraffin-embedded samples obtained at primary diagnosis (Table 1). RNA from a training set of 19 indolent and 20 aggressive NHL cases was analyzed on a high-throughput quantitative real-time PCR (qRT-PCR) platform assessing the expression of 365 miRs and 3 endogenous controls (TaqMan Human MicroRNA Array v1.0: TLDA, ABI) using the DDCt method. A two-sample Wilcoxon Rank sum test corrected for false discovery rate was used to assess the significance of differential expression for each miR between aggressive and indolent NHL. The 14 most significantly differentially expressed miRs (p<0.001, FDR<0.02) were validated on an independent set of 25 indolent NHL and 19 aggressive NHL by qRT-PCR, and analyzed using the DDCt method. Univariate analysis using a one-sided t-test yielded 9 miRs that validated on the independent NHL set. Multivariable analysis demonstrated the ability of this 9 miR signature to distinguish between aggressive and indolent NHL (p<0.0001). Applying this signature to a set of 32 MCL patients with complete outcome data (Table 2) separated a poor prognosis group (median OS: 15 months, range: 4–40 months) from a good prognosis group (median OS: 88 months, range: 41–131 months) (Fig. 1). Among the 9 miRs were miR-29c, shown to have some prognostic value in MCL by Zhao et al., and miR-26a, shown to be important in MCL pathogenesis by Di Lisio et al. In light of the overlap with such recent studies, we believe the 9 miR prognostic signature we have identified may be of clinical utility. We are currently identifying mRNA targets for this miR signature and validating both the signature and the deregulated expression of these targets on a larger set of 200 MCL samples with known outcome data.

Fig. 1.

Psrincipal component analysis demonstrating separation of MCL cases into a good prognosis group in red (median OS: 88 months, range: 41–131 months) and a poor prognosis group in blue (median OS: 15 months, range: 4–40 months) based on expression of a 9 miR aggressiveness signature.

Fig. 1.

Psrincipal component analysis demonstrating separation of MCL cases into a good prognosis group in red (median OS: 88 months, range: 41–131 months) and a poor prognosis group in blue (median OS: 15 months, range: 4–40 months) based on expression of a 9 miR aggressiveness signature.

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Table 1.

Sample breakdown

Training setNumber
Aggressive cases   
Diffuse large B-cell lymphoma  
Primary mediastinal B-cell lymphoma  
Burkitt lymphoma  
Atypical Burkitt  
Indolent cases   
Small lymphocytic lymphoma/CLL  
Extranodal marginal zone lymphoma  
Follicular lymphoma Grade 1 
 Grade 2 
 Grade 3a 
Validation set   
Aggressive cases   
Diffuse large B-cell lymphoma  
Primary mediastinal B-cell lymphoma  
Burkitt lymphoma  
Atypical Burkitt  
Indolent cases   
Small lymphocytic lymphoma/CLL  
Extranodal marginal zone lymphoma  
Follicular lymphoma Grade 1 
 Grade 2 
 Grade 3a 
MCL cases   
Conventional  19 
Blastoid/pleomorphic  11 
Prolymphocytoid  
Multiple lymphomatoid polyposis  
   
Normal benign lymph nodes  20 
TOTAL  135 
Training setNumber
Aggressive cases   
Diffuse large B-cell lymphoma  
Primary mediastinal B-cell lymphoma  
Burkitt lymphoma  
Atypical Burkitt  
Indolent cases   
Small lymphocytic lymphoma/CLL  
Extranodal marginal zone lymphoma  
Follicular lymphoma Grade 1 
 Grade 2 
 Grade 3a 
Validation set   
Aggressive cases   
Diffuse large B-cell lymphoma  
Primary mediastinal B-cell lymphoma  
Burkitt lymphoma  
Atypical Burkitt  
Indolent cases   
Small lymphocytic lymphoma/CLL  
Extranodal marginal zone lymphoma  
Follicular lymphoma Grade 1 
 Grade 2 
 Grade 3a 
MCL cases   
Conventional  19 
Blastoid/pleomorphic  11 
Prolymphocytoid  
Multiple lymphomatoid polyposis  
   
Normal benign lymph nodes  20 
TOTAL  135 

Table 2.

MCL clinical data

FeaturesTotal%
Gender Male 23 72 
 Female 28 
ECOG 12 38 
 17 53 
 2-3 
Stage 
 25 
 22 
 15 47 
 B symptoms 28 
 Extranodal sites 16 
Lines of therapy 
 14 44 
 
 19 
 
 >4 13 
Types of therapy Observation alone 
 Anthracycline-based 18 56 
 Rituximab 14 44 
 SCT 
 Bortezomib 
 Radiation 14 44 
FeaturesTotal%
Gender Male 23 72 
 Female 28 
ECOG 12 38 
 17 53 
 2-3 
Stage 
 25 
 22 
 15 47 
 B symptoms 28 
 Extranodal sites 16 
Lines of therapy 
 14 44 
 
 19 
 
 >4 13 
Types of therapy Observation alone 
 Anthracycline-based 18 56 
 Rituximab 14 44 
 SCT 
 Bortezomib 
 Radiation 14 44 

MedianRange
Age (yrs) 69 37–90 
M-IPI score 6.6 5.3–8.7 
Ki-67 (%) 25 7.5–90 
Time to 1st treatment (months) 0.8 0.1–99.1 
Overall survival (months) 34 4–131 
MedianRange
Age (yrs) 69 37–90 
M-IPI score 6.6 5.3–8.7 
Ki-67 (%) 25 7.5–90 
Time to 1st treatment (months) 0.8 0.1–99.1 
Overall survival (months) 34 4–131 

Disclosures:

Kuruvilla:Hoffman LaRoche: Honoraria, Research Funding; Celgene: Research Funding; Amgen: Honoraria; Otsuka: Honoraria; Genzyme: Honoraria.

Author notes

*

Asterisk with author names denotes non-ASH members.

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