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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

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

Funding

TB: Received Mayo Clinic Cancer Center Support Grant (P30 CA015083), serve in advisory board for Pfizer and Takeda AP: Consulting for Abbvie, research funding from Kronos Bio, Pfizer, Celgene/BMS, Servier, VK: Advisory board for Novartis and Pfizer, MS: Consulting for Curis Oncology, advisory board for Novartis, Kymera, Sierra Oncology, participated in GME activities for Novartis, Curis Oncology, Haymarket and Clinical Care Options.

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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