THE CLINICAL OUTCOME OF 65 CASES OF MANTLE CELL LYMPHOMA INITIALLY TREATED WITH NON-INTENSIVE THERAPY BY THE BRITISH NATIONAL LYMPHOMA INVESTIGATION GROUP

Mantle cell lymphoma (MCL) was first described as a distinct biologica l entity on the basis of its association with the t(11;14)(q13;q32) re sulting in over-expression of the cyclin D1 gene. Recognition of the m orphological, immunophenotypic and clinical characteristics of MCL has enabled the accurate diagnosis of this entity and appreciation of its poor prognosis. Most published series of patients with MCL have used anthracycline-containing regimens. In contrast the British National Ly mphoma Investigation (BNLI) group have treated 65 patients with MCL wi th nonintensive 'low-grade lymphoma' therapy. The median overall survi val of 57 months and progression-free survival of 24 months compares f avourably with the more intensively treated series. Although the disea se was generally more aggressive than other low-grade lymphomas, some patients were asymptomatic and had indolent disease. When compared to 1853 patients with non-MCL low-grade lymphomas entered on the BNLI dat abase, patients were found on average to be older (P = 0.02), to have more extranodal disease (P<0.00001), and a higher proportion to have a raised ESR (P = 0.02) and a low serum albumin (P = 0.002). Multivaria te analysis of significant prognostic markers in all BNLI low-grade ly mphomas failed to identify MCL as an independent prognostic factor.