title: Prognostic role of SOX11 in a population-based cohort of mantle cell lymphoma.
abstract: The prognostic role of the transcription factor SOX11 in mantle cell lymphoma (MCL) is controversial. We investigated prognostic markers in a population-based cohort of 186 MCL cases. Seventeen patients (9%) did not require any therapy within the first 2 years after diagnosis and were retrospectively defined as having an indolent disease. As expected, indolent MCL had less frequent B symptoms and extensive nodal involvement and 88% of these cases expressed SOX11. In our cohort 13 cases (7.5%) lacked nuclear SOX11 at diagnosis. SOX11(-) MCL had a higher frequency of lymphocytosis, elevated level of lactate dehydrogenase (LDH), and p53 positivity. The overall survival in the whole cohort, excluding 37 patients receiving autologous stem cell transplantation, was 3.1 year and in patients with indolent or nonindolent disease, 5.9 and 2.8 years, respectively (P = .004). SOX11(-) cases had a shorter overall survival, compared with SOX11(+) cases, 1.5 and 3.2 years, respectively (P = .014). In multivariate analysis of overall survival, age > 65 (P = .001), Eastern Cooperative Oncology Group score ≥ 2 (P = .022), elevated LDH level (P = .001), and p53 expression (P = .001) remained significant, and SOX11 lost significance. We conclude that most indolent MCLs are SOX11(+) and that SOX11 cannot be used for predicting an indolent disease course.
authors.affiliation: Department of Laboratory Medicine, Division of Pathology; Center for Haematology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lina
authors.initials: L
authors.lastname: Nygren
authors.forename: Stefanie
authors.initials: S
authors.lastname: Baumgartner Wennerholm
authors.forename: Monika
authors.initials: M
authors.lastname: Klimkowska
authors.forename: Birger
authors.initials: B
authors.lastname: Christensson
authors.forename: Eva
authors.initials: E
authors.lastname: Kimby
authors.forename: Birgitta
authors.initials: B
authors.lastname: Sander
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D002467:Cell Nucleus / Q000737:chemistry; D015331:Cohort Studies; D003131:Combined Modality Therapy; D019938:Cyclin D1 / Q000032:analysis; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D020522:Lymphoma, Mantle-Cell / Q000737:chemistry* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D011379:Prognosis; D055751:SOXC Transcription Factors / Q000032:analysis*; D014182:Transplantation, Autologous; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; C530104:CCND1 protein, human; D009363:Neoplasm Proteins; C097473:SOX11 protein, human; D055751:SOXC Transcription Factors; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D019938:Cyclin D1; D007770:L-Lactate Dehydrogenase