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

Nordström L, Sernbo S, Eden P, Grønbaek K, Kolstad A, Räty R, Karjalainen ML, Geisler C, Ralfkiaer E, Sundström C, Laurell A, Delabie J, Ehinger M, Jerkeman M, Ek S - Br. J. Haematol. (2014)

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.

View Article: PubMed Central - PubMed

Affiliation: Department of Immunotechnology, CREATE Health, Lund University, Lund, Sweden.

Show MeSH

Related in: MedlinePlus

Kaplan-Meier's estimate of overall survival and event-free survival in relation to MIPI, MIPI-B, SOX11/MIPI and TP53/MIPI. (A) OS and (B) EFS analysis using the Kaplan-Meier method reveal a poor separation between MIPIlow and MIPIintermediate groups. When applying the proposed biological MIPI (MIPI-B) both (C) OS and (D) EFS analysis show inverted low and intermediate survival curves. The combined SOX11/MIPI improves separation between low and intermediate risk groups (although, P > 0·05) in relation to (E) OS and (F) EFS. The combined TP53/MIPI show significant (P = 0·006) separation between low and intermediate risk groups in relation to (G) OS and identifies a high risk group with decreased (H) EFS. OS, overall survival; EFS, event-free survival; MIPI, Mantle cell lymphoma International Prognostic Index; MIPI-B, biological MIPI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4282019&req=5

fig03: Kaplan-Meier's estimate of overall survival and event-free survival in relation to MIPI, MIPI-B, SOX11/MIPI and TP53/MIPI. (A) OS and (B) EFS analysis using the Kaplan-Meier method reveal a poor separation between MIPIlow and MIPIintermediate groups. When applying the proposed biological MIPI (MIPI-B) both (C) OS and (D) EFS analysis show inverted low and intermediate survival curves. The combined SOX11/MIPI improves separation between low and intermediate risk groups (although, P > 0·05) in relation to (E) OS and (F) EFS. The combined TP53/MIPI show significant (P = 0·006) separation between low and intermediate risk groups in relation to (G) OS and identifies a high risk group with decreased (H) EFS. OS, overall survival; EFS, event-free survival; MIPI, Mantle cell lymphoma International Prognostic Index; MIPI-B, biological MIPI.

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.


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

Nordström L, Sernbo S, Eden P, Grønbaek K, Kolstad A, Räty R, Karjalainen ML, Geisler C, Ralfkiaer E, Sundström C, Laurell A, Delabie J, Ehinger M, Jerkeman M, Ek S - Br. J. Haematol. (2014)

Kaplan-Meier's estimate of overall survival and event-free survival in relation to MIPI, MIPI-B, SOX11/MIPI and TP53/MIPI. (A) OS and (B) EFS analysis using the Kaplan-Meier method reveal a poor separation between MIPIlow and MIPIintermediate groups. When applying the proposed biological MIPI (MIPI-B) both (C) OS and (D) EFS analysis show inverted low and intermediate survival curves. The combined SOX11/MIPI improves separation between low and intermediate risk groups (although, P > 0·05) in relation to (E) OS and (F) EFS. The combined TP53/MIPI show significant (P = 0·006) separation between low and intermediate risk groups in relation to (G) OS and identifies a high risk group with decreased (H) EFS. OS, overall survival; EFS, event-free survival; MIPI, Mantle cell lymphoma International Prognostic Index; MIPI-B, biological MIPI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4282019&req=5

fig03: Kaplan-Meier's estimate of overall survival and event-free survival in relation to MIPI, MIPI-B, SOX11/MIPI and TP53/MIPI. (A) OS and (B) EFS analysis using the Kaplan-Meier method reveal a poor separation between MIPIlow and MIPIintermediate groups. When applying the proposed biological MIPI (MIPI-B) both (C) OS and (D) EFS analysis show inverted low and intermediate survival curves. The combined SOX11/MIPI improves separation between low and intermediate risk groups (although, P > 0·05) in relation to (E) OS and (F) EFS. The combined TP53/MIPI show significant (P = 0·006) separation between low and intermediate risk groups in relation to (G) OS and identifies a high risk group with decreased (H) EFS. OS, overall survival; EFS, event-free survival; MIPI, Mantle cell lymphoma International Prognostic Index; MIPI-B, biological MIPI.
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.

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.

View Article: PubMed Central - PubMed

Affiliation: Department of Immunotechnology, CREATE Health, Lund University, Lund, Sweden.

Show MeSH
Related in: MedlinePlus