Retrospective analysis of mantle cell lymphoma: experience of the "Gruppo Italiano per lo Studio dei Linfomi" (GISL)

Background and Objective. Mantle cell lymphoma is a recently recognized his tologic entity with specific biological and clinical features. Clinically, the reported unfavorable outcome of these patients has focused attention on this category of non-Hodgkin's lymphoma (NHL). Design and Methods. The slide specimens of 69 NHL patients, originally clas sified as Working Formulation (WF) group B and E, were reviewed. The clinic al features at presentation, response to therapy, response duration and sur vival were analyzed in cases reclassified as MCL. The correlation between c linical and histologic characteristics and the final outcome was evaluated. Results. Out of 69 cases, 34 specimens were reclassified as MCL; in 6 patie nts, previously classified as WF group B, the nodular pattern was confirmed ; in 2 instances the blastoid form was recognized. After a median follow-up of 35.7 months, the entire series displayed a median overall survival of 4 1.2 months; a significantly longer survival was associated with the nodular histologic pattern, IPI score <2, response achievement, and a higher Hb le vel. The vast majority of patients received anthracycline-containing combin ation chemotherapy. Complete remission rate was 38.8% and overall response rate was 67.6%; response achievement was significantly influenced only by H b level. Median response duration was 23.3 months. Interpretation and Conclusions. The present study confirms the unfavorable clinical course of MCL and the possible need for an alternative therapeutic strategy for this NHL category. Therefore, the correct identification of M CL at diagnosis appears of relevance. (C)1998, Ferrata Storti Foundation.