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Early detection of risk is crucial to assign MCL patients to novel treatment strategies. Most of the established biomarkers of outcome require specifically trained pathologists or molecular analysis. Here we introduce MAIPI (MCL Artificial Intelligence Prognostic Index), a deep learning algorithm trained only on Hematoxylin and Eosin (H&amp;E) images of diagnostic biopsies of\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009428 MCL patients from clinical trials to assess prognosis. The capability of MAIPI to predict disease outcome was validated in an independent cohort of\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009140 patients treated with immunochemotherapy with and without ibrutinib. 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