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Additional cytogenetic features determine outcome in patients allografted for TP53 mutant acute myeloid leukemia
Author(s) -
Loke Justin,
Labopin Myriam,
Craddock Charles,
Cornelissen Jan J.,
LabussièreWallet Hélène,
WagnerDrouet Eva Maria,
Van Gorkom Gwendolyn,
Schaap Nicolaas P.M.,
Kröger Nicolaus M.,
Veelken Joan Hendrik,
Rovira Montserrat,
Menard Anne Lise,
Bug Gesine,
Bazarbachi Ali,
Giebel Sebastian,
Brissot Eolia,
Nagler Ar,
Esteve Jordi,
Mohty Mohamad
Publication year - 2022
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.34268
Subject(s) - medicine , myeloid leukemia , cohort , cytogenetics , transplantation , leukemia , oncology , confidence interval , myeloid , gastroenterology , chromosome , genetics , gene , biology
BACKGROUND The presence of TP53 mutations is associated with an unfavorable outcome in patients allografted for acute myeloid leukemia (AML), leading some to question the benefit of an allogeneic stem cell transplantation (allo‐SCT) for this patient group, although this has not been studied in a large cohort. METHODS A total of 780 patients with AML in first complete remission, with either intermediate‐ or adverse‐risk cytogenetics, whose TP53 mutation status was reported, were included in this study from the European Society for Blood and Marrow Transplantation. RESULTS Two‐year overall survival (OS) was impaired in patients (n = 179) with evidence of a TP53 mutation at diagnosis (35.1%; 95% confidence interval [CI], 26.7–43.7) as compared to the cohort without (n = 601) (64%; 95% CI, 59.1–68.4; P = .001). In patients with mutant TP53 AML with no evidence of either chromosome 17p loss (17p–) and/or complex karyotype (CK) (n = 53, 29.6%), 2‐year OS was 65.2% (95% CI, 48.4–77.6). This was not significantly different to patients without TP53 mutations. In patients with mutant TP53 AML with either 17p– and/or CK (n = 126, 70.4%), the OS was lower (24.6%; 95% CI, 16.2–34; P = .001). CONCLUSIONS In summary, the adverse prognostic effect of TP53 mutations in AML following an allo‐SCT is not evident in patients with neither co‐occurring 17p– and/or CK, and these data inform decisions regarding allo‐SCT in patients with TP53 mutant AML.