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Updated: Apr 16, 2026
Tumor Engraftment in a Xenograft Mouse Model of Human Mantle Cell Lymphoma
Published on: March 30, 2018
Clinicopathologic features and management of blastoid variant of mantle cell lymphoma
Rajesh Shrestha1, Vijaya Raj Bhatt2, Guru Subramanian Guru Murthy3
1a Department of Internal Medicine , Memorial Hospital of Rhode Island , Pawtucket , RI , USA.
Insights
The blastoid variant of mantle cell lymphoma (MCL) is an aggressive subtype with frequent advanced-stage and extranodal involvement. Optimal therapy may involve aggressive immunochemotherapy and stem cell transplant for improved outcomes.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Blastoid variant mantle cell lymphoma (MCL) is an aggressive subtype, comprising less than one-third of all MCL cases.
- It can arise de novo or transform from classical MCL, predominantly affecting men in their sixth decade.
- Characterized by frequent extranodal involvement (40-60%), advanced stage IV disease (up to 85%), and central nervous system (CNS) involvement.
Purpose of the Study:
- To review the characteristics, diagnosis, and treatment of the blastoid variant of MCL.
- To highlight the challenges in diagnosis and the poor response to conventional chemotherapy.
- To discuss potential therapeutic strategies for improving patient outcomes.
Main Methods:
- Morphological assessment for diagnosis.
- Immunophenotyping including CD23, CD10, and CD5 expression analysis.
- Genetic analysis to identify complex genetic alterations.
Main Results:
- Diagnosis is challenging, relying on morphology with variable immunophenotypic findings (e.g., CD23/CD10 positivity, CD5 negativity in a subset).
- Increased complex genetic alterations are observed in the blastoid variant.
- Poor response to conventional chemotherapy with a short duration of response is noted.
Conclusions:
- The blastoid variant of MCL presents unique diagnostic and therapeutic challenges.
- CNS prophylaxis and aggressive immunochemotherapy followed by autologous stem cell transplant may improve remission rates and survival.
- Further research is essential to enhance understanding and clinical outcomes for this MCL subtype.
Abstract:
The blastoid variant of mantle cell lymphoma (MCL), which accounts for less than one-third of MCL, may arise de novo or as a transformation from the classical form of MCL. Blastoid variant, which predominantly involves men in their sixth decade, has frequent extranodal involvement (40-60%), stage IV disease (up to 85%) and central nervous system (CNS) involvement. Diagnosis relies on morphological features and is challenging. Immunophenotyping may display CD23 and CD10 positivity and CD5 negativity in a subset. Genetic analysis demonstrates an increased number of complex genetic alterations. Blastoid variant responds poorly to conventional chemotherapy and has a short duration of response. Although the optimal therapy remains to be established, CNS prophylaxis and the use of aggressive immunochemotherapy followed by autologous stem cell transplant may prolong the remission rate and survival. Further studies are crucial to expand our understanding of this disease entity and improve the clinical outcome.
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