Clinical outcomes and characteristics of patients with <i>TP53</i>-mutated acute myeloid leukemia or myelodysplastic syndromes: a single center experience*
Jan Philipp Bewersdorf, Rory M. Shallis, Lohith Gowda, Wei Wei, Karl Hager, Iris Isufi, Tae Kon Kim, Manoj M. Pillai, Stuart Seropian, Nikolai A. Podoltsev, Steven D. Gore, Alexa J. Siddon, Amer M. Zeidan
Abstract
Mutations in the tumor suppressor gene TP53 are detected in 5–10% of patients with acute myeloid leukemia (AML) and myelodysplastic syndromes. TP53 mutations have been associated with complex karyotypes, therapy-related malignancies, lower response rates to cytotoxic chemotherapy, and an overall adverse prognosis. In this single-center retrospective study, we analyzed the clinicopathologic characteristics and outcomes of 83 patients with TP53-mutated myeloid malignancies treated at Yale Cancer Center between 9/2015 and 5/2019. Complex karyotypes (n = 75; 90%) and therapy-related malignancies (n = 32; 39%) were common. Median overall survival (OS) was 7.6 months. Intensive chemotherapy did not improve OS compared to lower-intensity treatment for AML patients. Patients who underwent allogeneic hematopoietic stem cell transplant (alloHSCT) had a significantly longer median OS, despite relatively limited follow-up. In conclusion, our data confirm the limited efficacy of intensive chemotherapy approaches for TP53-mutated patients with myeloid neoplasms and suggest that a minority of patients achieve long-term survival with alloHSCT.