{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:51Z","timestamp":1787027811614,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Assessment of bone marrow infiltration (BMI) is part of the initial staging of mantle cell lymphoma (MCL), although BMI evaluated by biopsy (BMB) is not considered significant in the MIPI scales, and standardized recommendations remain lacking. Objectives: To evaluate the accuracy and prognostic impact of BMI assessed by PET\/CT and BMB in a large series of MCL patients. Methods: We deconstructed the IPI-NCCN, MIPI, and MIPI-c indices and considered BMI as positive if indicated by a BMB, PET\/CT scan, or a combination of both. Results: In the total cohort (n = 148), 110 patients had BMI detected by BMB and 33 by PET\/CT. The sensitivity of BMB was higher than that of PET\/CT (94.8% vs. 28.4%), as were its negative predictive value (84.2% vs. 27.8%) and accuracy (95.9% vs. 43.9%). In the total cohort, BMI detected by PET\/CT showed a significant predictive value for PFS (p = 0.027), while BMB demonstrated independent prognostic value only in combination with PET\/CT (p = 0.025). Among intensively treated patients (n = 128), PET\/CT had significant clinical impact on PFS (p = 0.030), and when combined with BMB, it provided independent prognostic value for both PFS and OS (p = 0.026 and p = 0.033, respectively). Based on these findings, we propose a prognostic model (MCL-PET-I) that incorporates BMI by PET\/CT, allowing for the identification of three groups with distinct clinical outcomes (p &lt; 0.0001 for PFS and p = 0.00025 for OS). Conclusions: In the upfront work of MCL, PET\/CT-based BMI has greater prognostic impact, while BMB remains essential for staging. We propose the MCL-PET-I prognostic index, which effectively differentiates between clinical risk groups.<\/jats:p>","DOI":"10.3390\/cancers16244189","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T12:09:28Z","timestamp":1734350968000},"page":"4189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Value of Bone Marrow Assessment by FDG PET\/CT, Biopsy and Aspirate in the Upfront Evaluation of Mantle Cell Lymphoma: A Nationwide Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-0914","authenticated-orcid":false,"given":"Isabel","family":"R\u00f3denas Qui\u00f1onero","sequence":"first","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Jos\u00e9 Mar\u00eda Morales Meseguer, IMIB-Pascual Parrilla, Centro de Investigaci\u00f3n Biom\u00e9dica en Red. Enfermedades Raras (CIBERER), 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-229X","authenticated-orcid":false,"given":"Javier","family":"Marco-Ayala","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Jos\u00e9 Mar\u00eda Morales Meseguer, IMIB-Pascual Parrilla, Centro de Investigaci\u00f3n Biom\u00e9dica en Red. Enfermedades Raras (CIBERER), 30008 Murcia, Spain"},{"name":"Department of Medicine, University of Murcia, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5969-8640","authenticated-orcid":false,"given":"Tzu-Hua","family":"Chen-Liang","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Jos\u00e9 Mar\u00eda Morales Meseguer, IMIB-Pascual Parrilla, Centro de Investigaci\u00f3n Biom\u00e9dica en Red. Enfermedades Raras (CIBERER), 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3866-8431","authenticated-orcid":false,"given":"F\u00e1tima","family":"de la Cruz-Vicente","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla (IBIS)\/Consejo Superior de Investigaciones Cient\u00edficas (CSIC)\/Universidad de Sevilla, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tycho","family":"Baumann","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9101-6013","authenticated-orcid":false,"given":"Jos\u00e9-Tom\u00e1s","family":"Navarro","sequence":"additional","affiliation":[{"name":"Lymphoid Neoplasms Group, Josep Carreras Leukaemia Research Institute (IJC), Department of Hematology, ICO-Hospital Germans Trias i Pujol Hospital, 08916 Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6330-1028","authenticated-orcid":false,"given":"Alejandro","family":"Mart\u00edn Garc\u00eda-Sancho","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario Salamanca, Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n Biom\u00e9dica en Red. C\u00e1ncer (CIBERONC), University of Salamanca, 37008 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taida","family":"Martin-Santos","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2969-3002","authenticated-orcid":false,"given":"Javier","family":"L\u00f3pez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Andreu","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Parra-Virto","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Usas","sequence":"additional","affiliation":[{"name":"Lymphoid Neoplasms Group, Josep Carreras Leukaemia Research Institute (IJC), Department of Hematology, ICO-Hospital Germans Trias i Pujol Hospital, 08916 Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Alonso","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario Salamanca, Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n Biom\u00e9dica en Red. C\u00e1ncer (CIBERONC), University of Salamanca, 37008 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Fern\u00e1ndez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1618-0905","authenticated-orcid":false,"given":"Pablo","family":"Palomo Rumschisky","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Frutos","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Navarro","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Alvarez-Perez","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Virgen del Roc\u00edo, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1415-345X","authenticated-orcid":false,"given":"Pilar","family":"Sarandeses","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Cortes","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7466-514X","authenticated-orcid":false,"given":"Pilar","family":"Tamayo","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Cl\u00ednico Universitario de Salamanca\/IBSAL, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0012-8819","authenticated-orcid":false,"given":"Jon","family":"U\u00f1a","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Mart\u00ednez-Lorca","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Nuclear, Hospital La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3148-7037","authenticated-orcid":false,"given":"Mar\u00eda","family":"Lozano","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Jos\u00e9 Mar\u00eda Morales Meseguer, IMIB-Pascual Parrilla, Centro de Investigaci\u00f3n Biom\u00e9dica en Red. Enfermedades Raras (CIBERER), 30008 Murcia, Spain"},{"name":"Department of Medicine, University of Murcia, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-9346","authenticated-orcid":false,"given":"Francisco","family":"Ortu\u00f1o","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Jos\u00e9 Mar\u00eda Morales Meseguer, IMIB-Pascual Parrilla, Centro de Investigaci\u00f3n Biom\u00e9dica en Red. Enfermedades Raras (CIBERER), 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1182\/blood-2007-06-095331","article-title":"A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma","volume":"111","author":"Hoster","year":"2008","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1200\/JCO.2015.63.8387","article-title":"Prognostic Value of Ki-67 Index, Cytology, and Growth Pattern in Mantle-Cell Lymphoma: Results From Randomized Trials of the European Mantle Cell Lymphoma Network","volume":"34","author":"Hoster","year":"2016","journal-title":"J. Clin. 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