Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): A clinicopathological study from the European MCL Network

Markus Tiemann, Carsten Schrader, Wolfram Klapper, Martin H. Dreyling, Elias Campo, Andrew Norton, Francoise Berger, Philip Kluin, German Ott, Stephano Pileri, Ennio Pedrinis, Alfred C. Feller, Hartmut Merz, Dirk Janssen, Martin L. Hansmann, Han Van Krieken, Peter Möller, Harald Stein, Michael Unterhalt, Wolfgang HiddemannReza Parwaresch

Research output: Contribution to journalArticle

Abstract

Mantle cell lymphoma (MCL) is a distinct lymphoma subtype with a particularly poor clinical outcome. The clinical relevance of the morphological characteristics of these tumours remains uncertain. The European MCL Network reviewed 304 cases of MCL to determine the prognostic significance of histopathological characteristics. Cytomorphological subtypes, growth pattern and markers of proliferation (mitotic and Ki-67 indices) were analysed. In addition to the known cytological subtypes, classical (87.5%), small cell (3.6%), pleomorphic (5.9%) and blastic (2.6%), we identified new pleomorphic subgroups with mixtures of cells (classical + pleomorphic type; 1.6%) or transitions (classical/pleomorphic type; 1.6%), which, however, did not differ significantly in overall survival time. Exactly 80.5% of cases displayed a diffuse growth pattern, whereas 19.5% of cases had a nodular growth pattern, which was associated with a slightly more favourable prognosis. A high proliferation rate (mitotic or Ki-67 indices) was associated with shorter overall survival. Cut-off levels were defined that allowed three subgroups with different proliferation rates to be discriminated, which showed significantly different clinical outcomes (P <0.0001). Based on this large clinicopathological study of prospective clinical trials, multivariate analysis confirmed the central prognostic role of cell proliferation and its superiority to all other histomorphological and clinical criteria.

Original languageEnglish
Pages (from-to)29-38
Number of pages10
JournalBritish Journal of Haematology
Volume131
Issue number1
DOIs
Publication statusPublished - Oct 2005

Keywords

  • Cytology
  • Growth pattern
  • Ki-67 index
  • Mantle cell lymphoma
  • Mitotic index

ASJC Scopus subject areas

  • Hematology

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    Tiemann, M., Schrader, C., Klapper, W., Dreyling, M. H., Campo, E., Norton, A., Berger, F., Kluin, P., Ott, G., Pileri, S., Pedrinis, E., Feller, A. C., Merz, H., Janssen, D., Hansmann, M. L., Van Krieken, H., Möller, P., Stein, H., Unterhalt, M., ... Parwaresch, R. (2005). Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): A clinicopathological study from the European MCL Network. British Journal of Haematology, 131(1), 29-38. https://doi.org/10.1111/j.1365-2141.2005.05716.x