Expression of TP53 is associated with outcome of MCL independent of MIPI and Ki-67 in trials of the European-MCL Network

Abstract

Currently, prediction of time to treatment failure and overall survival in mantle cell lymphoma is based on the clinical factors included in the mantle cell lymphoma international prognostic index (MIPI) and proliferation assessed by Ki67. However, P53 and SOX11 immunohistochemistry might improve risk stratification. We performed SOX11 and P53 immunohistochemistry on the so far largest published cohort of lymphoma specimens (n=365). All patients were treated in prospective trials of the European MCL Network. In multivariate analyses including MIPI and Ki67, SOX11 expression was not associated with time to treatment failure but patients with low SOX11 expression had shorter overall survival. On the contrary, high P53 expression was a strong predictor of time to treatment failure and inferior overall survival compared to low P53 expression in univariate and multivariate analyses adjusting for MIPI and Ki-67 (hazard ratio 2.0, p=0.0054 for time to treatment failure and 2.1, p=0.068 for overall survival). Particularly patients with high P53 expression (>50% positive lymphoma cells) had a shorter time to treatment failure and poor overall survival independent of both MIPI and Ki-67. Thus, P53 immunohistochemistry is a suitable test for routine diagnostic practice to assess mantle cell lymphoma prognosis.