Increased proliferation rate, as measured by Ki67 immunostaining, is regarded as a high-risk prognostic factor in both the frontline and relapsed settings.
Although MCL does not carry a favorable prognosis overall, patients with MCL with prior classic histology whose histologic variant evolves to blastoid and pleomorphic histology at relapse are at high risk for poor outcomes.
A strong association between TP53 mutations and inferior outcomes following treatment with either intensive chemoimmunotherapy or Bruton tyrosine kinase inhibitors has been demonstrated, per Bond and colleagues. Furthermore, the same authors note that TP53 mutations are frequently associated with a high proliferation rate.
Other negative prognostic features include various high-risk genetic features such as mutations within NOTCH1, NOTCH2, and KMT2D and mutations or copy number loss of CDKN2A.
Learn more about the management of patients newly diagnosed with MCL.
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Cite this: Elwyn C. Cabebe, Ann S. LaCasce. Fast Five Quiz: Management of Mantle Cell Lymphoma - Medscape - Jan 26, 2023.