SOX11 and TP53 add prognostic information to MIPI in a homogenously treated cohort of mantle cell lymphoma--a Nordic Lymphoma Group study.
Bottom Line: Furthermore, we explored the possibility of creating an improved prognostic tool by combining the MIPI with information on molecular markers.SOX11 was shown to significantly add prognostic information to the MIPI, but in multivariate analysis TP53 was the only significant independent molecular marker.Based on these findings, we propose that TP53 and SOX11 should routinely be assessed and that a combined TP53/MIPI score may be used to guide treatment decisions.
Affiliation: Department of Immunotechnology, CREATE Health, Lund University, Lund, Sweden.Show MeSH
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Mentions: As previously discussed, patients with low and intermediate MIPI are poorly separated based on survival in the Nordic MCL2/3 cohort (Fig3A, B). It has previously been suggested that MKI67 may add prognostic value to MIPI (Hoster et al, 2008) but the MIPI-B also failed to separate the low and intermediate risk groups in this combined cohort (Fig3C, D). The multimodality of the cohort was investigated by Gaussian Mixture Model analysis, optimizing maximum likelihood and evaluating with the Akaike Information Criterion (Akaike, 1974). This analysis confirmed that the cohort is bimodal in MIPI, with a transition point at 5·92 (where both risk groups are equally probable). However, to be able to compare the novel proposed indices with previous studies of MIPI, the low, intermediate and high risk groups, and the sizes thereof, were kept constant when visualizing the indices using Kaplan Meier.
Affiliation: Department of Immunotechnology, CREATE Health, Lund University, Lund, Sweden.