Clinical characteristics and overall survival among acute myeloid leukemia patients with TP53 gene mutation or chromosome 17p deletion.

Autor: Daver NG; University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Iqbal S; Gilead Sciences, Inc., Foster City, California, USA., Huang J; Gilead Sciences, Inc., Foster City, California, USA., Renard C; Gilead Sciences, Inc., Foster City, California, USA., Lin J; Gilead Sciences, Inc., Foster City, California, USA., Pan Y; Gilead Sciences, Inc., Foster City, California, USA., Williamson M; Gilead Sciences, Inc., Foster City, California, USA., Ramsingh G; Gilead Sciences, Inc., Foster City, California, USA.
Jazyk: angličtina
Zdroj: American journal of hematology [Am J Hematol] 2023 Aug; Vol. 98 (8), pp. 1176-1184. Date of Electronic Publication: 2023 May 04.
DOI: 10.1002/ajh.26941
Abstrakt: Approximately 5% to 15% of acute myeloid leukemia (AML) patients have TP53 gene mutations (TP53m), which are associated with very poor outcomes. Adults (≥18 years) with a new AML diagnosis were included from a nationwide, de-identified, real-world database. Patients receiving first-line therapy were divided into three cohorts: venetoclax (VEN) + hypomethylating agents (HMAs; Cohort A), intensive chemotherapy (Cohort B), or HMA without VEN (Cohort C). A total of 370 newly diagnosed AML patients with TP53m (n = 124), chromosome 17p deletion (n = 166), or both (n = 80) were included. The median age was 72 years (range, 24-84); most were male (59%) and White (69%). Baseline bone marrow (BM) blasts were ≤30%, 31%-50%, and >50% in 41%, 24%, and 29% of patients in Cohorts A, B, and C, respectively. BM remission (<5% blasts) with first-line therapy was reported in 54% of patients (115/215) overall, and 67% (38/57), 62% (68/110), and 19% (9/48) for respective cohorts (median BM remission duration: 6.3, 6.9, and 5.4 months). Median overall survival (95% CI) was 7.4 months (6.0-8.8) for Cohort A, 9.4 months (7.2-10.4) for Cohort B, and 5.9 months (4.3-7.5) for Cohort C. There were no differences in survival by treatment type after adjusting for the effects of relevant covariates (Cohort A vs. C adjusted hazard ratio [aHR] = 0.9; 95% CI, 0.7-1.3; Cohort A vs. B aHR = 1.0; 95% CI, 0.7-1.5; and Cohort C vs. B aHR = 1.1; 95% CI, 0.8-1.6). Patients with TP53m AML have dismal outcomes with current therapies, demonstrating the high unmet need for improved treatments.
(© 2023 The Authors. American Journal of Hematology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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