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Oncotarget

TP53 Mutated AML: Transplant or No Transplant

Oct 11, 2024
Explore the challenges of treating TP53 mutated acute myeloid leukemia, which afflicts 10-15% of cases and shows poor responses to traditional therapies. Discover that allogeneic hematopoietic stem cell transplantation could improve survival rates, particularly when done during complete remission. Dive into research revealing a somber average survival of only 8.5 months without significant differences between treatments, highlighting the transplant's crucial role in managing this difficult condition.
03:49

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Quick takeaways

  • TP53 mutations in AML lead to resistance against conventional therapies and result in a poor prognosis, yet allo-HCT shows potential for improved survival.
  • Allo-HCT performed during complete remission significantly enhances long-term outcomes compared to transplants conducted after multiple lines of therapy.

Deep dives

The Impact of TP53 Mutations on AML Prognosis

TP53 mutations occur in 10-15% of acute myeloid leukemia (AML) cases and are particularly associated with therapy-related AML and complex cytogenetics. These mutations lead to inherent resistance to conventional chemotherapy, resulting in poor treatment outcomes, even with venetoclax-based therapies. A study evaluating outcomes of TP53 mutated AML patients revealed a stark average survival rate of only 8.5 months, showing no significant improvements across various treatment types. Despite the bleak overall prognosis, allogeneic hematopoietic stem cell transplant (allo-HCT) emerged as the only significant variable correlated with improved survival, indicating its potential as a curative option for these patients despite low overall uptake rates of 10 to 15%.

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