SOX11 and TP53 add prognostic information to MIPI in a homogenously treated cohort of mantle cell lymphoma – a Nordic Lymphoma Group study

• DOI: 10.1111/bjh.12854
• Publication Date: 2014-03-29T06:03:49Z
• Authors: Lena Nordström; Sandra Sernbo; Patrik Eden; Kirsten Grønbæk; Arne Kolstad; Riikka Räty; Marja‐Liisa Karja...; Christian Geisler; Elisabeth Ralfkiær; Christer Sundström; Anna Laurell; Jan Delabie; Mats Ehinger; Mats Jerkeman; Sara Ek
• Keywords: Adult; Male; Lymphoma; Adolescent; Lymphoma, Mantle-Cell; Severity of Illness Index; SOXC Transcription Factors; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Humans; Cyclin D1; Child; Tumor Markers; Aged; Neoplasm Staging; Haematological Malignancy; Mantle-Cell; Biological; Prognosis; Survival Analysis; Neoplasm Proteins; 3. Good health; Treatment Outcome; Female; Tumor Suppressor Protein p53

SummaryMantle cell lymphoma (MCL) is an aggressive B cell lymphoma, where survival has been remarkably improved by use of protocols including high dose cytarabine, rituximab and autologous stem cell transplantation, such as the NordicMCL2/3 protocols. In 2008, aMCLinternational prognostic index (MIPI) was created to enable stratification of the clinical diverseMCLpatients into three risk groups. So far, use of theMIPIin clinical routine has been limited, as it has been shown that it inadequately separates low and intermediate risk group patients. To improve outcome and minimize treatment‐related morbidity, additional parameters need to be evaluated to enable risk‐adapted treatment selection. We have investigated the individual prognostic role of theMIPIand molecular markers includingSOX11,TP53 (p53),MKI67 (Ki‐67) and CCND1 (cyclin D1). Furthermore, we explored the possibility of creating an improved prognostic tool by combining theMIPIwith information on molecular markers.SOX11 was shown to significantly add prognostic information to theMIPI, but in multivariate analysisTP53 was the only significant independent molecular marker. Based on these findings, we propose thatTP53 andSOX11 should routinely be assessed and that a combinedTP53/MIPIscore may be used to guide treatment decisions.