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Microvessel density of mantle cell lymphoma. A retrospective study of its prognostic role and the correlation with the Ki-67 and the mantle cell lymphoma international prognostic index in 177 cases

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Abstract

The clinical course and therapy of mantle cell lymphoma (MCL) are heterogeneous and often unsatisfactory. Prognostic factors are needed to stratify the patients. Microvessel density (MVD) has prognostic significance in some malignancies. There is little information about the vasculature of MCL, although some antiangiogenic drugs are in use. We studied MVD using systematic uniform random sampling and unbiased counting frames in immunohistochemical reactions with anti-CD34 antibody in pre-therapeutic extramedullary MCL samples of 177 patients. We analyzed the relationship of MVD to overall survival (OS) and progression-free survival (PFS), as well as to proliferative activity (Ki-67), mantle cell lymphoma prognostic index (MIPI), morphological variant, pattern of growth, and localization. MVD varied widely: range 54.6–503.6 vessels/mm2, median 158.2 vessels/mm2. Higher MVD was associated with bone marrow infiltration at the time of diagnosis (P = 0.001). High MVD was associated with significantly worse OS (P = 0.04) only in patients treated with non-intensive (conventional) therapy. MVD correlated positively with MIPI scores but not with the proliferation, morphological variant, growth pattern, or localization. Univariate analysis identified a prognostic influence of morphological variant, MIPI, and proliferative activity on OS and PFS and a prognostic influence of bone marrow infiltration at the time of diagnosis on PFS. Multivariate analysis showed prognostic influence of MIPI and proliferative activity on OS and PFS only. In conclusion, this is the first clinicopathological study of MVD of MCL with long-term follow-up showing negative prognostic trends of high MVD in MCL and positive correlation of MVD and MIPI.

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Acknowledgments

The help of many participating physicians and data managers providing clinical information and pathological specimens is greatly acknowledged. This study was supported in part by research grants of the Ministry of Education and Youth of the Czech Republic MSM0021620819 (LB), by the Charles University in Prague, Project No. P36 (ZT), and by the grant of the Internal Grant Agency of the Ministry of Health of the Czech Republic IGA MZ CR NT 12193-5 (LB, PV, DS, MT, on behalf of CLSG).

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Authors and Affiliations

  1. Sikl’s Department of Pathology, Faculty of Medicine in Pilsen, Charles University in Prague and University Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic

    Pavla Veselá, Michal Michal & Ludmila Boudová

  2. Biomedical centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic

    Zbyněk Tonar

  3. Department of Internal Medicine, Hematology and Oncology, University Hospital and Masaryk University, Brno, Czech Republic

    David Šálek

  4. Department of Hematooncology, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic

    Samuel Vokurka

  5. First Department of Medicine, Charles University and General University Hospital, Prague, Czech Republic

    Marek Trněný

  6. Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Faculty Hospital in Motol, Prague, Czech Republic

    Roman Kodet

  7. Department of Pathology, Masaryk University and University Hospital, Brno, Czech Republic

    Mojmír Moulis

  8. Fingerland Department of Pathology, Faculty of Medicine and Faculty Hospital, Charles University, Hradec Kralove, Czech Republic

    Petra Kašparová

  9. Department of Pathology, Third Faculty of Medicine, Charles University, Prague, Czech Republic

    Zdeňka Vernerová

  10. Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

    Zuzana Velenská & Jan Stříteský

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  1. Pavla Veselá
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Correspondence to Ludmila Boudová.

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Veselá, P., Tonar, Z., Šálek, D. et al. Microvessel density of mantle cell lymphoma. A retrospective study of its prognostic role and the correlation with the Ki-67 and the mantle cell lymphoma international prognostic index in 177 cases. Virchows Arch 465, 587–597 (2014). https://doi.org/10.1007/s00428-014-1632-4

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