IPI and R-IPI
https://thehematologist.org/lymphoma-prognosis-scores/
FLIPI and FLIPI 2
https://thehematologist.org/follicular-lymphoma-international-prognostic-index-flipi-and-flipi-2/
MIPI
Mantle cell low risk:
SOX 11 neg
Ki 67 less than 10 %
Hypermutated IGHV
Stable karyotype
Mantle high risk:
TP53 mutated
Complex karyotype
Blastoid/pleomorphic
Ki 67 % greater than 30%
Who can you watch and wait in Mantle cell?
Leukemic or non nodal, no B symptoms, Ki 67 less than 10 percent, normal LDH, mutated IGHV. MIPI not useful.
Updates in MCL
1. BOVEN trial: zanubrutinib+ obin+len in TP53 mutated 1L
https://ash.confex.com/ash/2023/webprogram/Paper180069.html
2. TRIANGLE trial: FFT improved with ibrutinib front line with or without ASCT.
3. BRIDGE trial : frontline zanubrutinib in a triangle regimen
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