Ki-67 predicts outcome in advanced-stage mantle cell lymphoma patients treated with anti-CD20 immunochemotherapy: results from randomized trials of the European MCL Network and the German Low Grade Lymphoma Study Group
Olaf Determann, Eva Hoster, German Ott, Heinz Wolfram Bernd, Christoph Loddenkemper, Martin Leo Hansmann, Thomas E F Barth, Michael Unterhalt, Wolfgang Hiddemann, Martin Dreyling, Wolfram Klapper, European Mantle Cell Lymphoma Network and the German Low Grade Lymphoma Study Group, Middendorf Nitsche, Weikersthal, Müller Hahn, Dravoj Gensicke, Schmid Schlimok, Meusner Langer, Siegert Possinger, Matylis Ludwig, Angrick Weh, Ev Rhode, Krankenhaus Bietigheim Dietrich, Graeven Schmiegel, Röhl Musch, Jordan Wörmann, Diekmann Pflüger, Neser Hänel, Carl-Thiem-Klinikum Peter, Heike, Lange, Haas, Rösler, Wehle-Ilka Fuchs, Nückel Dührsen, Wattad Heit, Hartwigsen Saal, Synowzik Reiber, Finke Mertelsmann, Höffkes Fassbinder, Stelzer Heil, Schliesser, Glasse Trümper, Lindemann Eimermacher, Hausbrandt Kraus, Wolf Schmoll, Möller Spohn, Rohrberg Hurtz, Nickelsen Schmitz, Kröger Zander, Bokemeyer, Walter, Schmidt, Henne, Dietzfelbinger, Sievers Basler, Pfreundschuh, Gasiorek, Fricke Höffken, Wilhelm Bentz, Göckel Mezger, Zutavern-Bechtold Mosthaf, Söling Siehl, Urbanke-Siebert Löser, Kneba, Nolte Eisenhauer, Nowak Helmer, Reiser Hallek, Fokken, Schwarzer Aldaoud, Matthé Mantovani, Baumgarten, Jost Heidenreich, Nothnagel Liebau, Hoffmann Uppenkamp, Schmelar Fetscher, Trebing-Lukas Heil, Jentsch-Ullrich Franke, Krötki Kettner, Fischer Huber, Lengfelder Hehlmann, Schwella Neubauer, Wöltjen Bodenstein, Kreisel-Büstgens Becker, Jehner Götz, Kohl Graeven, Lunscken, Dreyling Forstpointner, Schiel Hentrich, Tigges Abenhardt, Berdel, Lerchenmüller Wehmeyer, Ladda, Nürnberg, Heuser, Jungblut Ehscheidt, Wandt Wilhelm, Ballo Böck, Metzner Henning-Köhne, Zirpel Otremba, Niemeyer Wolff, Sandritter Theilmann, Gmelin, Rothmann Maschmeyer, Ruprecht Kautzsch, Krause Andreesen, Kreuser, Krammer-Steiner Neeck, Freund, Schult Hähling, Käfer Seitz, Schleicher Mergenthaler, Martin Aulitzky, Ehr Höring, Kaesberger Heidemann, Fiechtner, Kubin Biedermann, Weber Kölbel, Clemens, Arztpraxis Forstbauer, Reiter, Bias Brettner, Rövekamp Vedder, Müller Katz, Bock, Becker Sandmann, Weissinger Einsele, Schlag, Kreibich, Olaf Determann, Eva Hoster, German Ott, Heinz Wolfram Bernd, Christoph Loddenkemper, Martin Leo Hansmann, Thomas E F Barth, Michael Unterhalt, Wolfgang Hiddemann, Martin Dreyling, Wolfram Klapper, European Mantle Cell Lymphoma Network and the German Low Grade Lymphoma Study Group, Middendorf Nitsche, Weikersthal, Müller Hahn, Dravoj Gensicke, Schmid Schlimok, Meusner Langer, Siegert Possinger, Matylis Ludwig, Angrick Weh, Ev Rhode, Krankenhaus Bietigheim Dietrich, Graeven Schmiegel, Röhl Musch, Jordan Wörmann, Diekmann Pflüger, Neser Hänel, Carl-Thiem-Klinikum Peter, Heike, Lange, Haas, Rösler, Wehle-Ilka Fuchs, Nückel Dührsen, Wattad Heit, Hartwigsen Saal, Synowzik Reiber, Finke Mertelsmann, Höffkes Fassbinder, Stelzer Heil, Schliesser, Glasse Trümper, Lindemann Eimermacher, Hausbrandt Kraus, Wolf Schmoll, Möller Spohn, Rohrberg Hurtz, Nickelsen Schmitz, Kröger Zander, Bokemeyer, Walter, Schmidt, Henne, Dietzfelbinger, Sievers Basler, Pfreundschuh, Gasiorek, Fricke Höffken, Wilhelm Bentz, Göckel Mezger, Zutavern-Bechtold Mosthaf, Söling Siehl, Urbanke-Siebert Löser, Kneba, Nolte Eisenhauer, Nowak Helmer, Reiser Hallek, Fokken, Schwarzer Aldaoud, Matthé Mantovani, Baumgarten, Jost Heidenreich, Nothnagel Liebau, Hoffmann Uppenkamp, Schmelar Fetscher, Trebing-Lukas Heil, Jentsch-Ullrich Franke, Krötki Kettner, Fischer Huber, Lengfelder Hehlmann, Schwella Neubauer, Wöltjen Bodenstein, Kreisel-Büstgens Becker, Jehner Götz, Kohl Graeven, Lunscken, Dreyling Forstpointner, Schiel Hentrich, Tigges Abenhardt, Berdel, Lerchenmüller Wehmeyer, Ladda, Nürnberg, Heuser, Jungblut Ehscheidt, Wandt Wilhelm, Ballo Böck, Metzner Henning-Köhne, Zirpel Otremba, Niemeyer Wolff, Sandritter Theilmann, Gmelin, Rothmann Maschmeyer, Ruprecht Kautzsch, Krause Andreesen, Kreuser, Krammer-Steiner Neeck, Freund, Schult Hähling, Käfer Seitz, Schleicher Mergenthaler, Martin Aulitzky, Ehr Höring, Kaesberger Heidemann, Fiechtner, Kubin Biedermann, Weber Kölbel, Clemens, Arztpraxis Forstbauer, Reiter, Bias Brettner, Rövekamp Vedder, Müller Katz, Bock, Becker Sandmann, Weissinger Einsele, Schlag, Kreibich
Abstract
Clinical outcome of mantle cell lymphoma (MCL) is highly heterogeneous. Tumor cell proliferation as assessed by the Ki-67 index has been shown to yield prognostic information on MCL in many studies using heterogeneously treated patient cohorts. The prognostic value of the Ki-67 index in patients treated with anti-CD20 therapy has not been studied so far. We analyzed the Ki-67 index at primary diagnosis in 249 advanced-stage MCL patients treated within randomized trials. Ki-67 showed high prognostic relevance for overall survival (relative risk 1.27 for 10% higher Ki-67, P < .001), also independently from clinical prognostic factors. The 3 groups with different Ki-67 index of less than 10%, 10% to less than 30%, and 30% or more showed significantly different overall survival in patients treated with CHOP (P = .001) as well as in patients treated with CHOP in combination with anti-CD20 therapy (R-CHOP, P = .013). Thus, the Ki-67 index remains an important prognostic marker in the era of anti-CD20 therapy. The Euro-pean MCL study is registered at www.ClinicalTrials.gov as #NCT00016887.
Source: PubMed