Impact of <i>TP53</i> mutation on survival outcomes in acute lymphoblastic leukemia at a tertiary center
Mutations in <i>TP53</i> in acute lymphoblastic leukemia (ALL) predict poor outcomes, however, the literature in adults remains limited. In a retrospective study at Cleveland Clinic, we investigated the outcomes of 72 patients with next-generation sequencing (NGS) at baseline out of 161 patients from January 2017 to August 2023. Eleven patients had TP53 mutations (muTP53-ALL) (15.3%). Patients with muTP53-ALL were older (65 vs 56 years), had more high-risk cytogenetics (45% vs 16%), and no BCR-ABL1 rearrangements (34% vs 0) compared to wild-type TP53 (wt<i>TP53</i>). The muTP53-ALL group had lower flow-cytometry measurable residual disease (MRD)-negative responses (odds ratio: 0.1, 95%CI 0.01-0.47.8, <i>p</i> = .003) and worse 12-month overall survival (OS) compared to wtTP53 ALL (62% vs 90%, <i>p</i> = 0.023). The muTP53-ALL patients are less likely to achieve deep responses to first-line therapy and have worse long-term OS. Future studies should explore early transplants or the use of front-line immunotherapies to improve outcomes.
Authors
- Jinan Chen (ORCID: https://orcid.org/0000-0003-1169-563X)
- John C. Molina (ORCID: https://orcid.org/0000-0003-3142-516X)
- Hetty E. Carraway (ORCID: https://orcid.org/0000-0001-5241-3614)
- Moaath K. Mustafa Ali (ORCID: https://orcid.org/0000-0003-3289-2333)
- Aaron T. Gerds (ORCID: https://orcid.org/0000-0002-3422-1309)
- Joy Nakitandwe (ORCID: https://orcid.org/0000-0003-4648-0356)
- Akriti Gupta Jain (ORCID: https://orcid.org/0000-0002-7238-9241)
- Abhay Singh (ORCID: https://orcid.org/0000-0001-6657-8647)
- Sophia Balderman (ORCID: https://orcid.org/0000-0001-8157-8725)
- Emily Craig Zabor (ORCID: https://orcid.org/0000-0002-1402-4498)
- Ahmed Allam Mohamed (ORCID: https://orcid.org/0000-0002-0978-1996)
- Hadil Zureigat (ORCID: https://orcid.org/0000-0002-9593-2550)
- Anjali S. Advani (ORCID: https://orcid.org/0000-0003-0015-5902)
- Meera Patel (ORCID: https://orcid.org/0009-0002-6809-4608)
- Sudipto Mukherjee (ORCID: https://orcid.org/0000-0002-8325-2603)
- Zheng Jin Tu
Institutions
- Cleveland Clinic (US)
- Cancer Institute (WIA) (IN)
Publication Details
- Journal
- Leukemia & lymphoma/Leukemia and lymphoma
- Published
- 2025-04-09
- DOI
- https://doi.org/10.1080/10428194.2025.2482131
- Citations
- 4
- Primary Topic
- Acute Lymphoblastic Leukemia research
- Type
- article
- Field-Weighted Citation Impact
- 7.51