CD5-negative Mantle Cell Lymphoma: Clinicopathologic Correlations and Outcome in 58 Patients. (August 2019)

• Record Type: Journal Article
• Authors: Miao, Yuan; Lin, Pei; Saksena, Annapurna; Xu, Jie; Wang, Michael; Romaguera, Jorge; Yin, C. Cameron; Medeiros, L. Jeffrey; Li, Shaoying
• Is Part Of: American journal of surgical pathology. Volume 43:Number 8(2019)
• Publication Date: 2019-08
• Subjects: mantle cell lymphoma -- CD5− -- prognosis -- overall survival -- progression-free survival; Pathology, Surgical -- Periodicals; 617.0705
• DOI: 10.1097/PAS.0000000000001278
• Languages: English
• ISSNs: 0147-5185

Abstract

Abstract : Mantle cell lymphoma (MCL) represents 4% to 9% of all non-Hodgkin lymphomas and is characterized by CD5 and cyclin D1 expression and t(11;14)(q13;q32). However, about 5% of MCL lack CD5 expression and is poorly characterized. Here, we present 58 patients with CD5 negative (CD5 − ) MCL and compared them with a group of 212 typical CD5 positive (CD5 + ) MCL cases. There were 39 men and 19 women with a median age of 66 years (range, 36 to 88). Compared with CD5 positive (CD5 + ) MCL patients, patients with CD5 − MCL showed a lower male-to-female ratio ( P =0.006) and a higher frequency of "bone marrow non-nodal" presentation ( P =0.01). All other clinicopathologic features, including the frequency of SOX11 expression, were similar between the 2 groups. Treated with similar regimens, patients with CD5 − MCL showed a significantly longer progression-free survival (PFS) ( P =0.01) and a tendency for longer overall survival (OS; P =0.078) than CD5 positive (CD5 + ) MCL patients. Univariate analysis showed of the well-known poor prognostic factors, only Mantle Cell Lymphoma International Prognostic Index was an inferior prognostic factor and blastoid/pleomorphic morphology and high Ki67 were not associated with prognosis in CD5 − MCL patients. Multivariate Cox regression analysis showed CD5 expression was an independent prognostic factor for PFS ( P =0.031) but not OS in MCL patients. In conclusion, the results suggest that patients with CD5 − MCL have a more favorable prognosis than CD5 + MCL patients, although the clinicopathologic features of both groups are largely similar. CD5 − MCL may represent a distinct variant of MCL and needs to be included in the differential diagnosis of CD5 − small B-cell lymphomas.