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Blood, 15 February 2008, Vol. 111, No. 4, pp. 2385-2387.
Prepublished online as a Blood First Edition Paper on December 12, 2007; DOI 10.1182/blood-2007-10-117010.
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NEOPLASIA
Brief Report
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 Determann1,
Eva Hoster2,
German Ott3,4,
Heinz Wolfram Bernd5,
Christoph Loddenkemper6,
Martin Leo Hansmann7,
Thomas E. F. Barth8,
Michael Unterhalt2,
Wolfgang Hiddemann2,
Martin Dreyling2,
Wolfram Klapper1, for the European Mantle Cell Lymphoma Network and the German Low Grade Lymphoma Study Group
1 Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel, Kiel;
2 Department of Internal Medicine III, University of Munich, Munich;
3 Department of Pathology, University of Würzburg, Würzburg;
4 Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart;
5 Department of Pathology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck;
6 Department of Pathology, University Hospital Charité, Campus Benjamin-Franklin, Berlin;
7 Department of Pathology, University of Frankfurt, Frankfurt; and
8 Department of Pathology, University of Ulm, Ulm, Germany
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
[ClinicalTrials.gov]
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