A RECENT multicenter study led by researchers including Talha Badar and Moazzam Shahzad has highlighted the challenging prognosis of TP53-mutated acute myeloid leukemia (AML), which accounts for 10–15% of cases and is often resistant to standard therapies. Despite advancements in treatments, patients with TP53 mutations experience a grim median survival of just 8.5 months.
The study analyzed data from the COMMAND consortium, focusing on 370 TP53-mutated AML patients treated between 2012 and 2021. Remarkably, only 16% of patients were successfully bridged to allogenic hematopoietic stem cell transplant (allo-HCT), the sole factor associated with improved survival. Among those who underwent transplant, median overall survival reached 24.5 months, with notable differences depending on the timing of the transplant.
Patients receiving allo-HCT in complete remission after initial treatment had better outcomes compared to those who underwent salvage therapy. Furthermore, the study indicated that the presence of chronic graft-versus-host disease (cGVHD) and maintaining response at day 100 post-transplant significantly improved survival rates.
However, the study also revealed that complex cytogenetics negatively impacted outcomes, emphasizing the need for tailored strategies in this high-risk group. The findings underscore the potential of allo-HCT as a curative approach for TP53-mutated AML, despite the inherent challenges posed by the disease.
