Impact of TP53 mutation on survival outcomes in acute lymphoblastic leukemia at a tertiary center.

IF 2.2 4区医学 Q3 HEMATOLOGY

Leukemia & Lymphoma Pub Date : 2025-04-09 DOI:10.1080/10428194.2025.2482131

Meera Patel, Emily C Zabor, Ahmed Mohamed, Hadil Zureigat, Mark Jinan Chen, Joy Nakitandwe, Zheng Jin Tu, Akriti G Jain, John C Molina, Sophia Balderman, Abhay Singh, Aaron T Gerds, Sudipto Mukherjee, Hetty E Carraway, Anjali S Advani, Moaath K Mustafa Ali

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Abstract

Mutations in TP53 in acute lymphoblastic leukemia (ALL) predict poor outcomes, however, the literature in adults remains limited. In a retrospective study at Cleveland Clinic, we investigated the outcomes of 72 patients with next-generation sequencing (NGS) at baseline out of 161 patients from January 2017 to August 2023. Eleven patients had TP53 mutations (muTP53-ALL) (15.3%). Patients with muTP53-ALL were older (65 vs 56 years), had more high-risk cytogenetics (45% vs 16%), and no BCR-ABL1 rearrangements (34% vs 0) compared to wild-type TP53 (wtTP53). The muTP53-ALL group had lower flow-cytometry measurable residual disease (MRD)-negative responses (odds ratio: 0.1, 95%CI 0.01-0.47.8, p = .003) and worse 12-month overall survival (OS) compared to wtTP53 ALL (62% vs 90%, p = 0.023). The muTP53-ALL patients are less likely to achieve deep responses to first-line therapy and have worse long-term OS. Future studies should explore early transplants or the use of front-line immunotherapies to improve outcomes.

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TP53突变对三级中心急性淋巴细胞白血病存活结果的影响。

急性淋巴细胞白血病（ALL）中TP53突变预测预后不良，然而，关于成人的文献仍然有限。在克利夫兰诊所的一项回顾性研究中，我们调查了2017年1月至2023年8月期间161名患者中72名患者的下一代测序（NGS）基线结果。11例患者有TP53突变（muTP53-ALL）（15.3%）。与野生型TP53 （wtTP53）相比，muTP53-ALL患者年龄较大（65岁vs 56岁），具有更高的高危细胞遗传学（45% vs 16%），并且没有BCR-ABL1重排（34% vs 0）。与wtTP53 ALL相比，muTP53-ALL组具有较低的流式细胞术可测量的残留疾病（MRD）阴性反应（优势比：0.1,95%CI 0.01-0.47.8, p = 0.003）和较差的12个月总生存率（OS）（62% vs 90%, p = 0.023）。muTP53-ALL患者不太可能对一线治疗产生深度反应，并且有更差的长期OS。未来的研究应该探索早期移植或使用一线免疫疗法来改善结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Leukemia & Lymphoma 医学-血液学

CiteScore

4.10

自引率

3.80%

发文量

384

审稿时长

1.8 months

期刊介绍： Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor