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Tandem Meetings 2026 | Baseline factors that should be assessed before selecting a frontline regimen for MCL
In this video, Krish Patel, MD, Sarah Cannon Research Institute, Nashville, TN, outlines baseline factors to assess in patients with mantle cell lymphoma (MCL) before selecting a frontline regimen. These include molecular factors and biomarkers, such as TP53 aberrations and Ki-67 expression, and IGHV-mutation status in individuals with indolent disease. This interview took place virtually.
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Transcript
Yeah, that’s a really important question. Because the disease can be heterogeneous, I think for all patients at diagnosis, it’s important to look for p53 aberrations. So to do that by NGS testing as well as FISH. Recall in mantle cell lymphoma, we are more likely to see mutations by NGS testing than we are, for example, deletion 17p, so you want to do both...
Yeah, that’s a really important question. Because the disease can be heterogeneous, I think for all patients at diagnosis, it’s important to look for p53 aberrations. So to do that by NGS testing as well as FISH. Recall in mantle cell lymphoma, we are more likely to see mutations by NGS testing than we are, for example, deletion 17p, so you want to do both. I think also making sure that our pathologists are reporting factors like Ki-67 and that we’re also, when possible, able to obtain cytogenetics to look for karyotype. So those would be three things that I think are important to look for in all patients with mantle cell lymphoma up front. And then, of course, having an expert pathologist who can identify those rare histologic subtypes like blastoid or pleomorphic mantle cell lymphoma helps us to think about the high-risk patients. For the indolent patients, it’s a little bit different. We see this leukemic non-nodal type of mantle cell lymphoma that is typically clinically defined, low number of lymph nodes involved, small lymph nodes, and typically these are patients that may have IGHV-mutated mantle cell lymphoma, and so that’s another molecular factor that may be important to look for upfront.
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