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)

Talha Badar, Ehab Atallah, Rory Shallis, Antoine N. Saliba, Anand Patel, Jan P. Bewersdorf, Justin Grenet, Maximilian Stahl, Adam Duvall, Madelyn Burkart, Neil Palmisiano, Danielle Bradshaw, Michal Kubiak, Shira Dinner, Aaron D. Goldberg, Yasmin Abaza, Guru Subramanian Guru Murthy, Vamsi Kota, Mark R. Litzow

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)799-806
Number of pages8
JournalLeukemia
Volume37
Issue number4
DOIs
StatePublished - Apr 2023

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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