A recent study accessed the Mayo Clinic database to investigate the long-term survival of patients with myeloproliferative neoplasms (MPNs) and acute myeloid leukaemia (AML) associated with multihit TP53 mutations (mTP53MUT). The analysis included 142 patients, spanning various stages of MPN, including chronic phase (MPN-CP), accelerated phase (MPN-AP), and blast phase (MPN-BP), as well as those with AML.
The study found that concurrent mutations in genes such as ASXL1, EZH2, and IDH were more common in MPN patients with mTP53MUT compared to those with AML. After a median follow-up of 11.6 months, 87% of patients died, and 13% underwent allogeneic stem cell transplants (ASCT). Survival outcomes varied across disease stages, with MPN-CP patients showing significantly better overall survival (OS) at 11.6 months compared to those in blast (4.6 months) or accelerated (5.6 months) phases.
Factors such as disease stage, response to pre-transplant chemotherapy, and ASCT significantly influenced survival, with a 3-tiered risk model categorising patients into low, intermediate, and high-risk groups based on these factors. The study underscores the critical impact of mTP53MUT on survival in both MPN and AML, highlighting the need for tailored treatment strategies.
Helena Bradbury, EMJ
Reference
Fathima S et al. Multihit TP53 mutations in myeloproliferative neoplasms and acute myeloid leukemia: Comparative analysis of survival and risk factors in 142 informative cases. American Journal of Hematology. 2025; https://doi.org/10.1002/ajh.27670.
