Overview of Acute Myeloid Leukemia with TP53 Mutation: Single Center, Real-Life Data

Selin Kucukyurt; Hacer Berna Afacan Öztürk; Lale Aydın Kaynar; Jale Yıldız; Haktan Bağiş Erdem; Birgül Ay Karakuş; Murat Albayrak; Merih Kızıl Çakar; Şahika Zeynep Akı; Ahmet Kürşad Güneş

Makale detayları

Overview of Acute Myeloid Leukemia with TP53 Mutation: Single Center, Real-Life Data

Yazarlar:

Selin Kucukyurt | Hacer Berna Afacan Öztürk | Lale Aydın Kaynar | Jale Yıldız | Haktan Bağiş Erdem | Birgül Ay Karakuş | Murat Albayrak | Merih Kızıl Çakar | Şahika Zeynep Akı | Ahmet Kürşad Güneş

Yayıncı:

Hitit University

Ana Başlıklar:

Hematoloji | İç Hastalıkları

Dergi:

Hitit Medical Journal Vol.7 Issue 2, pp.205-213

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001351603

pISSN:

2687-4717

Anahtar kelimeler:

Özet:

 Objective: Acute myeloid leukemia AML with TP53 mutations represents a distinct and high-risk molecular subgroup characterized by aggressive disease progression, chemoresistance, and poor survival outcomes. This study provides a single-center analysis of clinical characteristics, treatment responses, and survival outcomes in a real-world cohort of patients with TP53-mutated AML. Material and Method: A retrospective observational study was conducted at Ankara Etlik City Hospital, analyzing nine patients diagnosed with TP53-mutated AML between January 2023 and January 2024. Patients were treated with intensive or less intensive induction regimens based on patient-related factors. Cytogenetic and molecular abnormalities were recorded, alongside treatment responses were assessed per the European Leukemia Net 2022 guidelines. The primary endpoint was overall survival. Results: The median age at diagnosis was 65 years, with 55.5 female patients. Complex karyotypes were observed in 66.7 of cases, and multi-hit TP53 mutations were identified in two patients. A complete response was achieved in 75 of patients treated with intensive induction therapy 73, while a complete or partial response was achieved in 60 of patients receiving the azacitidine-venetoclax regimen. Six patients died within 12 months, predominantly due to infection, while the three surviving patients underwent for allogeneic hematopoietic stem cell transplantation allo-HSCT. The median overall survival OS of the entire cohort was 9 months. Patients with TP53-mutated AML who underwent allo-HSCT exhibited significantly prolonged OS p0.01. Conclusion: The prognosisof TP53-mutated AML remains particularly poor, highlighting an urgent need for the development of novel therapeutic approaches to improve patient outcomes. While allo-HSCT offers a potential survival benefit, effective bridging therapies and post-transplant management are critical for improving outcomes in this high-risk population.

 Objective: Acute myeloid leukemia AML with TP53 mutations represents a distinct and high-risk molecular subgroup characterized by aggressive disease progression, chemoresistance, and poor survival outcomes. This study provides a single-center analysis of clinical characteristics, treatment responses, and survival outcomes in a real-world cohort of patients with TP53-mutated AML. Material and Method: A retrospective observational study was conducted at Ankara Etlik City Hospital, analyzing nine patients diagnosed with TP53-mutated AML between January 2023 and January 2024. Patients were treated with intensive or less intensive induction regimens based on patient-related factors. Cytogenetic and molecular abnormalities were recorded, alongside treatment responses were assessed per the European Leukemia Net 2022 guidelines. The primary endpoint was overall survival. Results: The median age at diagnosis was 65 years, with 55.5 female patients. Complex karyotypes were observed in 66.7 of cases, and multi-hit TP53 mutations were identified in two patients. A complete response was achieved in 75 of patients treated with intensive induction therapy 73, while a complete or partial response was achieved in 60 of patients receiving the azacitidine-venetoclax regimen. Six patients died within 12 months, predominantly due to infection, while the three surviving patients underwent for allogeneic hematopoietic stem cell transplantation allo-HSCT. The median overall survival OS of the entire cohort was 9 months. Patients with TP53-mutated AML who underwent allo-HSCT exhibited significantly prolonged OS p0.01. Conclusion: The prognosisof TP53-mutated AML remains particularly poor, highlighting an urgent need for the development of novel therapeutic approaches to improve patient outcomes. While allo-HSCT offers a potential survival benefit, effective bridging therapies and post-transplant management are critical for improving outcomes in this high-risk population.

 Objective: Acute myeloid leukemia AML with TP53 mutations represents a distinct and high-risk molecular subgroup characterized by aggressive disease progression, chemoresistance, and poor survival outcomes. This study provides a single-center analysis of clinical characteristics, treatment responses, and survival outcomes in a real-world cohort of patients with TP53-mutated AML. Material and Method: A retrospective observational study was conducted at Ankara Etlik City Hospital, analyzing nine patients diagnosed with TP53-mutated AML between January 2023 and January 2024. Patients were treated with intensive or less intensive induction regimens based on patient-related factors. Cytogenetic and molecular abnormalities were recorded, alongside treatment responses were assessed per the European Leukemia Net 2022 guidelines. The primary endpoint was overall survival. Results: The median age at diagnosis was 65 years, with 55.5 female patients. Complex karyotypes were observed in 66.7 of cases, and multi-hit TP53 mutations were identified in two patients. A complete response was achieved in 75 of patients treated with intensive induction therapy 73, while a complete or partial response was achieved in 60 of patients receiving the azacitidine-venetoclax regimen. Six patients died within 12 months, predominantly due to infection, while the three surviving patients underwent for allogeneic hematopoietic stem cell transplantation allo-HSCT. The median overall survival OS of the entire cohort was 9 months. Patients with TP53-mutated AML who underwent allo-HSCT exhibited significantly prolonged OS p0.01. Conclusion: The prognosisof TP53-mutated AML remains particularly poor, highlighting an urgent need for the development of novel therapeutic approaches to improve patient outcomes. While allo-HSCT offers a potential survival benefit, effective bridging therapies and post-transplant management are critical for improving outcomes in this high-risk population.

 Amaç: TP53 mutasyonlu akut myeloid lösemi AML, agresif hastalık seyri, kemoterapi direnci ve kötü sağkalım sonuçlarıyla karakterize, yüksek riskli ve farklı bir moleküler alt grup olarak tanımlanır. Bu çalışma, TP53 mutasyonlu AML hastalarının klinik özelliklerini, tedavi yanıtlarını ve sağkalım sonuçlarını tek merkezden bir gerçek yaşam kohortunun analiziyle sunmaktadır. Gereç ve Yöntem: Ocak 2023 ile Ocak 2024 tarihleri arasında Ankara Etlik Şehir Hastanesinde TP53 mutasyonlu AML tanısı alan dokuz hastanın verileri retrospektif gözlemsel bir çalışmayla incelendi. Hastalar, hasta ile ilgili faktörlere bağlı olarak yoğun veya yoğun olmayan indüksiyon rejimleriyle tedavi edildi. Sitogenetik ve moleküler anomaliler kaydedildi ve tedavi yanıtları Avrupa Lösemi Ağı ELN 2022 kılavuzuna göre değerlendirildi. Birincil sonlanım noktası genel sağkalım idi. Bulgular: Tanı anındaki medyan yaş 65 olup, hastaların 55,5i kadındı. Olguların 66,7sinde kompleks karyotip gözlendi ve iki hastada çoklu-vuruş TP53 mutasyonları tespit edildi. Yoğun indüksiyon tedavisi 73 ile tedavi edilen hastaların 75inde tam yanıta ulaşılırken, azasitidin-venetoklaks rejimi alan hastaların 60ında tam veya kısmi yanıt elde edildi. Tanıdan sonraki 12 ay içinde altı hasta, çoğunlukla enfeksiyon nedeniyle hayatını kaybederken, hayatta kalan üç hasta allojeneik hematopoetik kök hücre nakli AHKHN yapılan hastalardı. Tüm kohortun ortanca genel sağkalımı 9 ay idi. AHKHN yapılan hastalarda genel sağkalım anlamlı şekilde daha uzundu p0,01. Sonuç: TP53 mutasyonlu AMLnin prognozu halen son derece kötü olmaya devam etmektedir ve bu durum hasta sonuçlarını iyileştirmek için yeni tedavi yaklaşımlarının geliştirilmesine acil ihtiyaç duyulduğunu göstermektedir. AHKHN potansiyel bir sağkalım faydası sunsa da, etkili köprüleme tedavileri ve nakil sonrası yönetim, bu yüksek riskli popülasyonda sonuçların iyileştirilmesinde kritiktir.

Makale detayları

Overview of Acute Myeloid Leukemia with TP53 Mutation: Single Center, Real-Life Data

Yazarlar:

Selin Kucukyurt | Hacer Berna Afacan Öztürk | Lale Aydın Kaynar | Jale Yıldız | Haktan Bağiş Erdem | Birgül Ay Karakuş | Murat Albayrak | Merih Kızıl Çakar | Şahika Zeynep Akı | Ahmet Kürşad Güneş

Yayıncı:

Hitit University

Ana Başlıklar:

Hematoloji | İç Hastalıkları

Dergi:

Hitit Medical Journal Vol.7 Issue 2, pp.205-213

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001351603

pISSN:

2687-4717

Acute myeloid leukemia

stem cell transplantation

survival

TP53 mutation

treatmentAkut myeloid lösemi

kök hücre nakli

sağkalım

tedavi

TP53 mutasyonu

Sayı

Makale detayları

Yazarlar: Selin Kucukyurt | Hacer Berna Afacan Öztürk | Lale Aydın Kaynar | Jale Yıldız | Haktan Bağiş Erdem | Birgül Ay Karakuş | Murat Albayrak | Merih Kızıl Çakar | Şahika Zeynep Akı | Ahmet Kürşad Güneş

Yayıncı: Hitit University

Ana Başlıklar: Hematoloji | İç Hastalıkları

Dergi: Hitit Medical Journal Vol.7 Issue 2, pp.205-213

Belge Tipi: Makale

Yayın Tarihi: 6/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001351603

pISSN: 2687-4717

Sayı

Yazarlar:

Selin Kucukyurt | Hacer Berna Afacan Öztürk | Lale Aydın Kaynar | Jale Yıldız | Haktan Bağiş Erdem | Birgül Ay Karakuş | Murat Albayrak | Merih Kızıl Çakar | Şahika Zeynep Akı | Ahmet Kürşad Güneş

Yayıncı:

Hitit University

Ana Başlıklar:

Hematoloji | İç Hastalıkları

Dergi:

Hitit Medical Journal Vol.7 Issue 2, pp.205-213

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001351603

pISSN:

2687-4717