Clinical outcomes and characteristics of patients with TP53-mutated acute myeloid leukemia or myelodysplastic syndromes: a single center experience*

被引：29

作者：

Bewersdorf, Jan Philipp ^{[1
]}

Shallis, Rory M. ^{[1
]}

Gowda, Lohith ^{[1
]}

Wei, Wei ^{[2
]}

Hager, Karl ^{[3
]}

Isufi, Iris ^{[1
]}

Kim, Tae Kon ^{[1
,4
]}

Pillai, Manoj M. ^{[1
]}

Seropian, Stuart ^{[1
]}

Podoltsev, Nikolai A. ^{[1
,5
]}

Gore, Steven D. ^{[1
,5
]}

Siddon, Alexa J. ^{[3
,6
]}

Zeidan, Amer M. ^{[1
,5
]}

机构：

[1] Yale Sch Med, Dept Internal Med, Sect Hematol, New Haven, CT USA

[2] Yale Sch Publ Hlth, Dept Biostat, New Haven, CT USA

[3] Yale Sch Med, Dept Lab Med, New Haven, CT USA

[4] Vanderbilt Univ, Med Ctr, Div Hematol Oncol, Nashville, TN USA

[5] Yale Univ, Canc Outcomes Publ Policy & Effectiveness Res Cop, New Haven, CT 06520 USA

[6] Yale Sch Med, Dept Pathol, Sect Hematopathol, New Haven, CT USA

来源：

LEUKEMIA & LYMPHOMA | 2020年 / 61卷 / 09期

基金：

美国国家卫生研究院;

关键词：

Acute myeloid leukemia; AML; TP53; myelodysplastic syndrome; MDS; stem cell transplant; INTERNATIONAL WORKING GROUP; VARIANT ALLELE FREQUENCY; CELL TRANSPLANTATION; SOMATIC MUTATIONS; RESPONSE CRITERIA; TP53; MUTATIONS; IMPACT; P53; DIAGNOSIS; AML;

D O I：

10.1080/10428194.2020.1759051

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：2180 / 2190

页数：11

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