What have we learned about TP53-mutated acute myeloid leukemia?

Abstract TP53 is a tumor suppressor gene frequently mutated in human cancers and is generally associated with poor outcomes. TP53 mutations are found in approximately 5% to 10% of patients with de novo acute myeloid leukemia (AML), more frequently observed in elderly patients and those with therapy-...

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Bibliographic Details
Main Authors: Moazzam Shahzad, Muhammad Kashif Amin, Naval G. Daver, Mithun Vinod Shah, Devendra Hiwase, Daniel A. Arber, Mohamed A. Kharfan-Dabaja, Talha Badar
Format: Article
Language:English
Published: Nature Publishing Group 2024-11-01
Series:Blood Cancer Journal
Online Access:https://doi.org/10.1038/s41408-024-01186-5
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Summary:Abstract TP53 is a tumor suppressor gene frequently mutated in human cancers and is generally associated with poor outcomes. TP53 mutations are found in approximately 5% to 10% of patients with de novo acute myeloid leukemia (AML), more frequently observed in elderly patients and those with therapy-related AML. Despite recent advances in molecular profiling and the emergence of targeted therapies, TP53-mutated AML remains a challenge to treat. Current treatment strategies, including conventional chemotherapy, hypomethylating agents, and venetoclax-based therapies, have shown limited efficacy in TP53-mutated AML, with low response rates and poor overall survival. Allogeneic hematopoietic stem cell transplantation is a potentially curative option; however, its efficacy in TP53-mutated AML depends on comorbid conditions and disease status at transplantation. Novel therapeutic modalities, including immune-based therapies, did show promise in early-phase studies but did not translate into effective therapies in randomized controlled trials. This review provides a comprehensive overview of TP53 mutations in AML, outcomes based on allelic burden, clinical implications, and therapeutic challenges.
ISSN:2044-5385