Acute Myeloid Leukemia (AML) with TP53 alteration and outcomes after allogeneic hematopoietic stem cell transplantation: A CIBMTR registry study

作者：Alexandra Gomez-Arteaga, Rory M. Shallis, Mariam T. Nawas, Landi Guo, Temitope Oloyede, Kwang Woo Ahn, Veronika Bachanová, Michael Byrne, Sergio Giralt, Lohith Gowda, Ann A. Jakubowski, Mark R. Litzow, Filippo Milano, Kristin Page, Wael Saber, Nelli Bejanyan, Larisa Broglie, Xinjie Xu, Jean A. Yared · 发表于：Blood · 年份：2025 · DOI：10.1182/blood-2025-1060 · 被引用次数：1 · 研究领域：Acute Myeloid Leukemia Research、Chronic Myeloid Leukemia Treatments、Protein Degradation and Inhibitors

Abstract Background: Acute myeloid leukemia (AML) with TP53 alteration (TP53alt), including deletion (TP53del) detected by cytogenetics (CG) (karyotype, FISH, or genomic microarray) and/or TP53 mutation (TP53mut) identified by next-generation sequencing, is associated with poor prognosis. However, a subset of patients may achieve long-term survival after allogeneic hematopoietic cell transplantation (allo-HCT). Patient-, disease-, and transplant-related variables may inform risk stratification and improve treatment decision-making in this high-risk population. We used the CIBMTR registry to investigate outcomes of patients with TP53alt AML undergoing allo-HCT. Methods: We included adult patients with 2017 ELN adverse-risk AML who underwent first allo-HCT between 2013–2019 and had available CG and molecular data. TP53del was centrally reviewed by expert cytogeneticist. Patients were stratified into three TP53alt groups: Group 1 (TP53mut+/ TP53del+), Group 2 (TP53mut −/ TP53del+), and Group 3 (TP53mut+/ TP53del −). The control group comprised patients with 2017 ELN adverse-risk AML negative for both TP53mut and TP53del. Patients from embargoed centers, lacking consent or comprehensive research data, or missing CG and molecular information were excluded. Results: Of 6,474 patients with adverse-risk AML, 703 patients with TP53alt met inclusion criteria: Group 1 (n=203), Group 2 (n=271), Group 3 (n=229). The control group included 2,763 patients. Median age was 58 years (44% ≥60);...