Eskelund CW et al. 

Summary - TP53 mutations identify a phenotypically distinct and highly aggressive form of mantel cell lymphoma (MCL) with poor or no response to regimens including cytarabine, rituximab, and autologous stem-cell transplant (ASCT).

Methods
The prognostic value of recurrent genetic aberrations was deternubed in diagnostic bone marrow specimens from 183 young MCL patients.

Results
TP53 (11%) and NOTCH1 (4%) mutations, and TP53 (16%) and CDKN2A (20%) deletions were associated with worse outcomes; however, based on multivariate analyses only TP53 mutations (HR=6.2) retained prognostic impact for OS, while TP53 mutations (HR=6.9) and MIPI-c high-risk (HR=2.6) had independent prognostic impact on time to relapse. 
TP53-mutated cases had a dismal outcome, with a median OS of 1.8 years and 50% relapsed at 1.0 years compared to 12.7 years for TP53-unmutated cases. 
TP53 mutations were significantly associated with Ki67>30%, blastoid morphology, MIPI high-risk, and inferior responses to both induction- and high-dose chemotherapy.