Cytogenetic Aberrations Characterize Mantle Cell Lymphoma With Bone Marrow Involvement and Provide The Most Important Prognostic Information

The clinical characteristics and cytogenetic aberrations of mantle cell lymphoma (MCL) is well described in the West, but not in China, and also not mentioned in patients with bone marrow involvement (BMI). The aim of this study was to characterize the clinical and cytogenetic feature of Chinese patients with MCL.

During the period July 2003 through November 2012, 50 MCL patients with BMI were diagnosed at our Hospital. Cytogenetic aberrations were detected by FISH on bone marrow cells, using a panel probes including Rb1, TP53, ATM and c-MYC.

The median age of the 50 patients was 55.5 years at diagnosis, with 38 male patients (76%). Eighteen patients had B symptom, 36 patients with splenomegaly, while 4 patients had hepatomegaly. Twenty-four of the forty-five patients had elevated serum LDH. According to MIPI system, 13 patients (27.7%) were classified into medium risk group, while 34 patients (72.3%) in the high risk prognosis group. In aspect of the cytogenetic aberrations, eleven of forty-two patients (26.2%) had Rb-1 deletion, 7/39 patients (17.9%) with ATM deletion, 16/42 patients (38.1%) with TP53 deletion, while 15/37 patients (40.5%) had c-MYC abnormality, including amplification and translocation.

With a median follow-up of 21.5 months, the median estimated progression-free survival (PFS) was 15 months (95% CI 8.6-21.4), and the median estimated overall survival (OS) was 27 months (95% CI 17.5-36.5). Using the Kaplan-Meier method, the MIPI high risk group, deletion of Rb-1, ATM, TP53 and c-MYC abnormality were the adverse prognostic factors for PFS, while deletion of Rb-1, ATM, TP53 and c-MYC abnormality predicted the worse OS in the univariate analysis. All other clinical characteristics did not significantly influence the PFS and OS(p>0.05). TP53 deletion and c-MYC abnormality were the independent prognostic factors for both of PFS and OS in the multivariate analysis.

The outcome of MCL with BMI was poor. TP53 deletion and c-MYC abnormality were common in MCL with BMI and represented the worst factors for survival.

No relevant conflicts of interest to declare.