New Risk Model Enhances Prognostic Precision in Mantle Cell Lymphoma

A large retrospective study published in Scientific Reports involving 979 patients from 9 cancer centers has introduced a powerful new prognostic tool for mantle cell lymphoma (MCL), a rare and aggressive form of non-Hodgkin lymphoma. The study confirms the utility of disease progression within 24 months (POD24) as a robust predictor of survival and establishes a new prognostic model that integrates POD24 with clinical variables, enabling more precise patient stratification.

Despite advances in therapies, prognosis after relapse remains poor. Existing prognostic models such as the MCL International Prognostic Index (MIPI) and Ki-67 have limited value in predicting the course of indolent disease, particularly in the modern therapeutic era.

The study found that 37.7% of evaluable patients experienced progression within 24 months. These patients with POD24 had a median overall survival (OS) of only 21 months, compared to 122 months for those without early progression. This substantial disparity highlights POD24 as a key stratifier of patient risk. The ROC curve analysis showed that POD24 was highly predictive of 3-year OS, with an area under the curve (AUC) of 0.797.

To enhance prognostic accuracy, researchers developed a nomogram combining POD24 with clinical factors such as age, lactate dehydrogenase (LDH) levels, MIPI score, splenomegaly, Ki-67 expression, and use of autologous stem cell transplant (ASCT). This integrated model demonstrated superior predictive performance, with an AUC of 0.869 for 3-year OS. Calibration curves confirmed high concordance between predicted and actual survival outcomes.

Notably, POD24 emerged as the single most powerful independent predictor of mortality. In multivariable Cox regression analysis, it was associated with a HR of 5.373 (95% CI, 3.984–7.247), indicating a significantly elevated risk of death in patients who relapsed within 2 years of diagnosis.

“Our study is the first to identify and validate a POD24-based prognostic model with clinical factors in [patients with MCL], which could serve as a stratification tool to guide patient counseling, treatment decisions, and follow-up scheduling,” the authors stated.

Although the study’s retrospective nature and lack of genetic profiling are limitations, it represents a significant step forward in addressing the unmet need for reliable prognostic tools in MCL. With mounting evidence supporting POD24’s predictive value, its integration into clinical workflows and policy considerations appears warranted.

Reference

He Y, Wang C, Pan T, et al. POD24-based prognostic signature enables personalized risk stratification in mantle cell lymphoma. Sci Rep. 2025;15:8687. doi:10.1038/s41598-025-92963-0