Features of TP53-mutated patients with chronic myelomonocytic leukemia in a national (ABCMML) and international cohort (cBIOPORTAL)

Big data collected in large international cooperations allow validation of findings from traditional national patient cohorts for proving consistency. In this study we analyzed outcomes and phenotypic features of TP53-mutated chronic myelomonocytic leukemia (CMML) patients in the Austrian biodatabase for CMML (ABCMML; n = 322) and in the international platform cBIOPORTAL (n = 399). The prevalences of TP53 mutations were 1.58 and 3.66, respectively. Numerically, overall survival was shorter in TP53-mutated patients in both cohorts (ABCMML 10.0 vs. 30.0 months and cBIOPORTAL 8.9 vs. 34.5 months), but this was statistically significant only in the cBIOPORTAL cohort. Decreased hemoglobin values and the presence of blast cells in peripheral blood were significantly associated with TP53 mutations in the cBIOPORTAL group but not in the ABCMML database. Our study indicates the necessity of sufficient patient numbers for the comparison of CMML patients regarding outcome and phenotype according to their molecular subtype, particularly in the case of rare mutations.