Survival of TP53-mutated acute myeloid leukemia patients receiving allogeneic stem cell transplantation after first induction or salvage therapy: Results from the Consortium on Myeloid Malignancies and Neoplastic Diseases (COMMAND) Journal Article
| Authors: | Badar, T.; Atallah, E.; Shallis, R.; Saliba, A. N.; Patel, A.; Bewersdorf, J. P.; Grenet, J.; Stahl, M.; Duvall, A.; Burkart, M.; Palmisiano, N.; Bradshaw, D.; Kubiak, M.; Dinner, S.; Goldberg, A. D.; Abaza, Y.; Murthy, G. S. G.; Kota, V.; Litzow, M. R. |
| Article Title: | Survival of TP53-mutated acute myeloid leukemia patients receiving allogeneic stem cell transplantation after first induction or salvage therapy: Results from the Consortium on Myeloid Malignancies and Neoplastic Diseases (COMMAND) |
| Abstract: | We conducted a multi-center study to analyze factors predicting survival among patients with TP53-mutated (m) AML receiving allogeneic hematopoietic stem cell transplant (allo-HSCT) in the recent era. Out of 370 TP53m AML patients, 68 (18%) patients were bridged to allo-HSCT. The median age of the patients was 63 years (range, 33–75), 82% of patients had complex cytogenetics and 66% of patients had multi-hit TP53m. Forty three percent received myeloablative conditioning and 57% received reduced intensity conditioning. The incidence of acute graft versus host disease (GVHD) was 37% and chronic GVHD was 44%. The median event-free survival (EFS) from the time of allo-HSCT was 12.4 months (95% CI: 6.24–18.55) and median overall survival (OS) was 24.5 months (95% CI: 21.80–27.25). In multivariate analysis utilizing variables that showed significance in univariate analysis, complete remission at day 100 post allo-HSCT retained significance for EFS (HR: 0.24, 95% CI: 0.10–0.57, p = 0.001) and OS (HR: 0.22, 95% CI: 0.10–0.50, p ≤ 0.001). Similarly, occurrence of chronic GVHD retained significance for EFS (HR: 0.21, 95% CI: 0.09–0.46, p ≤ 0.001) and OS (HR: 0.34, 95% CI: 0.15–0.75, p = 0.007). Our report suggests that allo-HSCT offers the best opportunity to improve long-term outcome among patients with TP53m AML. © 2023, The Author(s), under exclusive licence to Springer Nature Limited. |
| Keywords: | adult; controlled study; event free survival; aged; middle aged; survival analysis; retrospective studies; transplantation, homologous; gene mutation; major clinical study; overall survival; genetics; leukemia, myeloid, acute; allogeneic stem cell transplantation; clinical trial; salvage therapy; outcome assessment; disease association; incidence; cohort analysis; genetic association; cytogenetics; hematopoietic stem cell transplantation; pathology; retrospective study; protein p53; age; tumor suppressor gene; patient care; acute graft versus host disease; chronic graft versus host disease; myeloablative conditioning; multicenter study; leukemogenesis; graft versus host reaction; transplantation conditioning; tumor suppressor protein p53; graft vs host disease; tp53 protein, human; allotransplantation; leukemia remission; adverse event; complication; acute myeloid leukemia; procedures; humans; human; male; female; article |
| Journal Title: | Leukemia |
| Volume: | 37 |
| Issue: | 4 |
| ISSN: | 0887-6924 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2023-04-01 |
| Start Page: | 799 |
| End Page: | 806 |
| Language: | English |
| DOI: | 10.1038/s41375-023-01847-7 |
| PUBMED: | 36807649 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 May 2023 -- Source: Scopus |
