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Dutta, S; Pregartner, G; Rücker, FG; Heitzer, E; Zebisch, A; Bullinger, L; Berghold, A; Döhner, K; Sill, H.
Functional Classification of TP53 Mutations in Acute Myeloid Leukemia.
Cancers (Basel). 2020; 12(3): Doi: 10.3390/cancers12030637 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Leading authors Med Uni Graz
Dutta Sayantanee
Pregartner Gudrun
Sill Heinz
Co-authors Med Uni Graz
Berghold Andrea
Heitzer Ellen
Zebisch Armin
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Abstract:
Mutations of the TP53 gene occur in a subset of patients with acute myeloid leukemia (AML) and confer an exceedingly adverse prognosis. However, whether different types of TP53 mutations exert a uniformly poor outcome has not been investigated yet. Here, we addressed this issue by analyzing data of 1537 patients intensively treated within protocols of the German-Austrian AML study group. We classified TP53 mutations depending on their impact on protein structure and according to the evolutionary action (EAp53) score and the relative fitness score (RFS). In 98/1537 (6.4%) patients, 108 TP53 mutations were detected. While the discrimination depending on the protein structure and the EAp53 score did not show a survival difference, patients with low-risk and high-risk AML-specific RFS showed a different overall survival (OS; median, 12.9 versus 5.5 months, p = 0.017) and event-free survival (EFS; median, 7.3 versus 5.2 months, p = 0.054). In multivariable analyses adjusting for age, gender, white blood cell count, cytogenetic risk, type of AML, and TP53 variant allele frequency, these differences were statistically significant for both OS (HR, 2.14; 95% CI, 1.15-4.0; p = 0.017) and EFS (HR, 1.97; 95% CI, 1.06-3.69; p = 0.033). We conclude that the AML-specific RFS is of prognostic value in patients with TP53-mutated AML and a useful tool for therapeutic decision-making.

Find related publications in this database (Keywords)
acute myeloid leukemia
TP53 mutations
functional classification
relative fitness core
prognosis
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