Patients with low-density lipoprotein (LDL) receptor-related protein-associated protein 1 (LRPAP1) autoantibodies had better outcomes from mantle cell lymphoma (MCL), according to research published in Blood.

The authors obtained sera from patients treated in Germany within the European MCL Younger and Elderly trials. A total of 312 serum samples had LRPAP1 data and were included in the study. A total of 79% of patient samples were from males and the median age was 60 years.

LRPAP1 has previously been found in screening as a proliferation-inducing autoantigen of MCL. There were 13% (n = 41) of patients who had LRPAP1 autoantibodies. Patients with LRPAP1 autoantibodies had superior failure free survival (FFS), with a 5-year probability of 70% vs 51% without LRPAP1 autoantibodies (P =.0052). Patients with autoantibodies also had superior overall survival (OS), with a 5-year probability of 93% compared with 68% (P =.0142).

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The study authors also conducted a sensitivity analysis that used a more restrictive definition of LRPAP1 seropositivity, which confirmed the favorable FFS and OS.

There was no significant association between LRPAP1-autoantibody serostatus and minimal residual disease (MRD) status at the end of induction therapy or at 1 year. The presence of autoantibodies was also not associated with clinical baseline characteristics.

Patients with LRPAP1 autoantibodies had better FFS and OS when treated with immunochemotherapy independent of Mantle Cell Lymphoma International Prognostic Index (MIPI) score.

Based on results from this trial and previous studies, LRPAP1 remains an independent prognostic factor for MCL. The authors recommend future studies to independently validate the prognostic value of LRPAP1 seropositivity.


Thurner L, Fadle N, Bittenbring JT, et al. LRPAP1 autoantibodies in mantle cell lymphoma are associated with superior outcome. Blood. 2021;137(23):3251-3258. doi:10.1182/blood.2020008835