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Summary  Mantle 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 Nordic  MCL 2/3 protocols. In 2008, a  MCL  international prognostic index ( MIPI ) was created to enable stratification of the clinical diverse  MCL  patients into three risk groups. So far, use of the  MIPI  in 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 the  MIPI  and molecular markers including  SOX 11,  TP 53 (p53),  MKI 67 (Ki‐67) and CCND1 (cyclin D1). Furthermore, we explored the possibility of creating an improved prognostic tool by combining the  MIPI  with information on molecular markers.  SOX 11 was shown to significantly add prognostic information to the  MIPI , but in multivariate analysis  TP 53 was the only significant independent molecular marker. Based on these findings, we propose that  TP 53 and  SOX 11 should routinely be assessed and that a combined  TP 53/ MIPI  score may be used to guide treatment decisions.

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