Multihit mutations in the TP53 gene (mTP53MUT) have an equally detrimental effect on long-term survival in patients with both myeloproliferative neoplasms (MPN) like myelofibrosis (MF) and those with acute myeloid leukemia (AML), according to a new study published in the American Journal of Hematology. mTP53MUT could, therefore, be used as a predictor of short-term survival in both diseases.
These findings are based on the analysis of data from 142 patients from the Mayo Clinic database with mTP53MUT-associated MPN or AML. Of these patients, 14 had accelerated phase MPN, 19 had chronic phase MPN, 28 had blast phase MPN, and 81 had AML.
Mutations in the ASXL1, EZH2, IDH1, and IDH2 genes were more common in patients with blast-phase MPN and mTP53MUT compared to those with AML and mTP53MUT.
At a median follow-up of 11.6 months, 124 patients died, and 19 patients had an allogeneic stem cell transplantation.
Overall survival, which was calculated from the time of the detection of a mTP53MUT, was similar between patients with blast-phase and accelerated-phase MPN at 4.6 and 5.6 months, respectively.
However, overall survival was longer in patients with chronic phase MPN and mTP53MUT at 11.6 months, which was similar to overall survival in patients with AML and mTP53MUT, which was 7.4 months.
Multivariable analysis showed that disease stage, allogeneic stem cell transplantation, and response to pre-transplant chemotherapy positively affected overall survival while the presence of concurrent TET2 or DNMT3A mutations affected it negatively.