The prognostic impact of myeloid co-mutation burden in TP53-mutated AML/MDS after allogeneic stem cell transplantation: a multicenter retrospective analysis - PubMed
5 days ago
- #AML
- #allo-HSCT
- #TP53 mutation
- TP53 mutations in AML/MDS lead to poor prognosis, with allo-HSCT offering potential but suboptimal cure rates.
- A study of 66 TP53-mutated AML/MDS patients post-allo-HSCT showed 3-year OS, PFS, CIR, NRM, and GRFS rates of 47.2%, 39.7%, 37.3%, 23%, and 37.4%, respectively.
- Patients with <2 somatic myeloid co-mutations had worse OS (32% vs. 65.9%) and PFS (27.6% vs. 59.1%) compared to those with ≥2 co-mutations.
- Age >50 years negatively impacted PFS, and complex karyotype showed a negative trend in outcomes.
- A combined risk model (co-mutations <2 or complex karyotype) identified patients with significantly worse OS and PFS (72.6% vs. 37.2% and 67.7% vs. 28.9%, respectively).
- Low myeloid co-mutation burden (<2) strongly correlates with poor outcomes in TP53-mutated AML/MDS post-allo-HSCT.
- A composite model integrating co-mutation burden and karyotype may improve post-transplant risk stratification, especially when TP53 allelic status is uncertain.