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Summary: The mucosa‐associated lymphoid tissue (MALT) International Prognostic Index (IPI) was recently proposed as a prognostic index for patients with MALT lymphoma. We aimed to investigate the prognostic value of the serum β2‐microglobulin level in the context of MALT‐IPI, and we proposed a new prognostic index. Survival outcomes were analysed with regard to β2‐microglobulin level, MALT‐IPI, and the new prognostic index in MALT lymphoma patients (n = 571). The validity of the new prognostic index was assessed using an independent cohort (n = 216). Patients with high β2‐microglobulin levels had significantly worse progression‐free survival (PFS) and overall survival (OS) outcomes. A high β2‐microglobulin level was independently associated with poor PFS and OS. β2‐microglobulin levels further stratified patients in the MALT‐IPI intermediate‐risk group in terms of PFS and OS. A new prognostic index based on the MALT‐IPI and the β2‐microglobulin level, MALT‐IPI‐B, was proposed. The MALT‐IPI‐B was able to stratify patients into subgroups having distinct PFS and OS outcomes in both the training and validation cohorts. MALT‐IPI‐B enabled the identification of patients with poor survival outcomes who were classified into the intermediate‐risk group by the MALT‐IPI. In conclusion, this new β2‐microglobulin‐based prognostic index may have the specific advantage of identifying high‐risk patients who may require systemic treatment. [ABSTRACT FROM AUTHOR]

Summary: JCOG9801, a randomized phase III trial, reported that vincristine, cyclophosphamide, doxorubicin and prednisone (VCAP); doxorubicin, ranimustine and prednisone (AMP); and vindesine, etoposide, carboplatin and prednisone (VECP) (VCAP‐AMP‐VECP; mLSG15) showed superior clinical outcomes when compared to cyclophosphamide, doxorubicin, vincristine and prednisone every 2 weeks (CHOP‐14; mLSG19) in patients with untreated aggressive adult T‐cell leukaemia‐lymphoma (ATL). To identify patients who require VCAP‐AMP‐VECP, we conducted a supplementary analysis of JCOG9801. Overall, 105 patients were included and categorized into low‐ (n = 44), intermediate‐ (n = 54) and high‐risk (n = 7) groups according to the age‐adjusted ATL prognostic index (ATL‐PI). We excluded the high‐risk group due to small numbers of patients. VCAP‐AMP‐VECP did not show any superior trend for overall survival (OS) in the low‐risk group (hazard ratio: 1·04; 95% confidence interval: 0·54–2·04). Better OS was observed in the intermediate‐risk group treated with VCAP‐AMP‐VECP (hazard ratio: 0·65; 95% confidence interval: 0·36–1·19). In the intermediate‐risk group, the VCAP‐AMP‐VECP arm showed higher complete response rates than the CHOP‐14 arm (44·0% vs. 13·8%). The VCAP‐AMP‐VECP arm in both risk groups exhibited grade 4 thrombocytopenia, while grade 4 neutropenia was only observed in the intermediate‐risk group. VCAP‐AMP‐VECP remains suitable for the intermediate‐risk group, whereas its benefits appear modest in the low‐risk group. [ABSTRACT FROM AUTHOR]

Summary: Different models to investigate the prognosis of peripheral T cell lymphoma not otherwise specified (PTCL‐NOS) have been developed by means of retrospective analyses. Here we report on a new model designed on data from the prospective T Cell Project. Twelve covariates collected by the T Cell Project were analysed and a new model (T cell score), based on four covariates (serum albumin, performance status, stage and absolute neutrophil count) that maintained their prognostic value in multiple Cox proportional hazards regression analysis was proposed. Among patients registered in the T Cell Project, 311 PTCL‐NOS were retained for study. At a median follow‐up of 46 months, the median overall survival (OS) and progression‐free survival (PFS) was 20 and 10 months, respectively. Three groups were identified at low risk (LR, 48 patients, 15%, score 0), intermediate risk (IR, 189 patients, 61%, score 1–2), and high risk (HiR, 74 patients, 24%, score 3–4), having a 3‐year OS of 76% [95% confidence interval 61–88], 43% [35–51], and 11% [4–21], respectively (P < 0·001). Comparing the performance of the T cell score on OS to that of each of the previously developed models, it emerged that the new score had the best discriminant power. The new T cell score, based on clinical variables, identifies a group with very unfavourable outcomes. [ABSTRACT FROM AUTHOR]

We performed an external and multicentric validation of the nomogram and prognostic index ( PI) proposed by the MD Anderson Cancer Center to prognostically stratify chronic lymphocytic leukaemia ( CLL) patients in 1502 CLL cases. All six parameters involved in the nomogram and PI (age, sex, absolute lymphocyte count, number of lymph node groups, Rai stage and β2-microglobulin) were independently associated with survival. The nomogram was accurate in predicting survival (c-index = 0·82). According to the PI, 38·7% of patients were at low-risk, 58·3% at intermediate-risk and 3% at high-risk. The estimated median survival times were: not reached for low-risk, 13·4 years for intermediate-risk and 3·4 years for high-risk. The estimated median and 5-year survival by PI were similar to those originally reported. The PI remained a predictor of survival when analysis was limited to 847 Rai stage 0 ( P < 0·0001) and 151 clinical monoclonal B-cell lymphocytosis ( cMBL) cases ( P = 0·033). Finally, the PI allowed prediction of time to therapy in all patients ( P < 0·0001), in Rai 0 ( P < 0·0001) and in cMBL cases ( P = 0·044). Our results confirm the ability of the PI to predict prognosis, even in early stage disease cases. The study also extended the utility of the PI to cMBL cases. [ABSTRACT FROM AUTHOR]

This study evaluated the clinical features of 276 patients with aggressive adult T-cell leukaemia-lymphoma (ATL) in 3 Japan Clinical Oncology Group (JCOG) trials. We assessed the long-term survivors who survived >5 years and constructed a prognostic index (PI), named the JCOG-PI, based on covariates obtained by Cox regression analysis. The median survival time (MST) of the entire cohort was 11 months. In 37 patients who survived >5 years, no disease-related deaths in 10 patients with lymphoma-type were observed in contrast to the 10 ATL-related deaths in other types. In multivariate analysis of 193 patients, the JCOG-PI based on corrected calcium levels and performance status identified moderate and high risk groups with an MST of 14 and 8 months respectively (hazard ratio, 1·926). The JCOG-PI was reproducible in an external validation. Patients with lymphoma-type who survived >5 years might have been cured. The JCOG-PI is valuable for identifying patients with extremely poor prognosis and will be useful for the design of future trials combining new drugs or investigational treatment strategies. [ABSTRACT FROM AUTHOR]

The International Prognostic Index (IPI) is the most commonly used prognostic model for mantle cell lymphoma (MCL). However, the prognostic value of the IPI is limited. The recently published Follicular Lymphoma International Prognostic Index (FLIPI) is built on variables, which are pertinent to MCL. This study was conducted to evaluate the prognostic value of FLIPI in a population-based series of 93 patients with MCL diagnosed in a 7-year period. End points of the study were response to therapy, overall survival, and disease-free survival (DFS) according to the IPI and FLIPI. Applied to the whole series, the FLIPI identified three risk groups with markedly different outcome with 5-year overall survival rates of 65%, 42%, and 8% respectively. Notably, the high-risk group comprised 53% of patients. In contrast, the IPI only allocated 16% of cases to the high-risk group and had a lower overall predictive capacity. When both the FLIPI and IPI were included in a multivariate analysis, only the FLIPI was related to survival. Multivariate analysis of DFS also identified the FLIPI, and not the IPI, as independently significant. Thus, in the present study, the FLIPI was superior as a prognostic model compared with the IPI and can therefore be recommended as a clinical prognostic index for MCL. [ABSTRACT FROM AUTHOR]

Data on 1711 patients, aged up to 55 years, in the MRC AML 10 trial were used to create a prognostic index for use in risk-directed therapy decision making for younger patients with acute myeloid leukaemia (AML). Two parameters, response after course 1 and cytogenetics, were strongly predictive of outcome. For patients with complete remission, partial remission and resistant disease, 5-year survival from the start of course 2 was 53%, 44% and 22% and relapse rates were 46%, 48% and 69% respectively, and for patients with favourable, intermediate and adverse karyotypic abnormalities, survival was 72%, 43% and 17% and relapse rates were 34%, 51% and 75% respectively (all P < 0.0001). Patients with FAB type M3 but no cytogenetic t(15;17) also had a low relapse rate (29%). These three factors were combined to give three risk groups: good (favourable karyotype or M3, irrespective of response status or presence of additional abnormalities), standard (neither good nor poor), poor (adverse karyotype or resistant disease, and no good-risk features). Survival for these three groups was 70%, 48% and 15% respectively and relapse rates were 33%. 50% and 78% (both P < 0.0001). The index is simple (based on just three parameters), robust (derived from 1711 patients), highly discriminatory (55% survival difference between good and poor risk) and validated, so can be applied in the clinical setting to assist with therapeutic decisions as in the current AML 12 trial. [ABSTRACT FROM AUTHOR]

The article offers information on the prognostic impact of monocyte count focused on the mantle cell lymphoma. It offers information on the front-line aggressive strategies including autologous stem cell transplantation (ASCT) and rituximab in the management of mantle cell lymphoma (MCL). It presents information on the prognostic value of the absolute monocyte count (AMC) in MCL.