Impact of TP53 mutation clearance prior to allo-HCT
| Author . | Study type . | Pts with TP53 mut receiving allo-HCT . | Level of TP53 clearance at time of allo-HCT . | Impact of TP53 clearance on post-HCT outcome . |
|---|---|---|---|---|
| MDS | ||||
| Yoshizato et al26 | Registry | 58 pts | n/a | Fraction of TP53 mutated cells at time of HCT significantly correlated with shorter time from transplantation to death |
| Dillon et al36 | Phase 3 randomized∗ | 12 pts | n/a | 3 pts survived without relapse, all with pre-HCT VAF < 5% (53-mo median follow-up in all survivors on study) |
| Hunter et al13 | Single center | 16 pts | VAF < 5% | Pts with TP53 mut clearance before allo-HCT experienced OS benefit compared to pts treated with HMA alone (25.2 vs 7.7 mo; P = .005), but pts with TP53 persistence did not |
| Versluis et al35 | Biological assignment trial† | 35 pts (subset with samples available) | VAF < 5% VAF < 2% | Pts with TP53 mut clearance before allo-HCT (at either threshold) did not experience OS benefit |
| AML | ||||
| Murdock et al37 | Single center | 33 pts | VAF < 0.1% | Pts with TP53 mut clearance before allo-HCT did not experience DFS benefit |
| Badar et al38 | Registry | 68 pts | “Clearance by NGS testing,” not otherwise defined | Pts with TP53 mut clearance before allo-HCT did not experience DFS benefit |
| Author . | Study type . | Pts with TP53 mut receiving allo-HCT . | Level of TP53 clearance at time of allo-HCT . | Impact of TP53 clearance on post-HCT outcome . |
|---|---|---|---|---|
| MDS | ||||
| Yoshizato et al26 | Registry | 58 pts | n/a | Fraction of TP53 mutated cells at time of HCT significantly correlated with shorter time from transplantation to death |
| Dillon et al36 | Phase 3 randomized∗ | 12 pts | n/a | 3 pts survived without relapse, all with pre-HCT VAF < 5% (53-mo median follow-up in all survivors on study) |
| Hunter et al13 | Single center | 16 pts | VAF < 5% | Pts with TP53 mut clearance before allo-HCT experienced OS benefit compared to pts treated with HMA alone (25.2 vs 7.7 mo; P = .005), but pts with TP53 persistence did not |
| Versluis et al35 | Biological assignment trial† | 35 pts (subset with samples available) | VAF < 5% VAF < 2% | Pts with TP53 mut clearance before allo-HCT (at either threshold) did not experience OS benefit |
| AML | ||||
| Murdock et al37 | Single center | 33 pts | VAF < 0.1% | Pts with TP53 mut clearance before allo-HCT did not experience DFS benefit |
| Badar et al38 | Registry | 68 pts | “Clearance by NGS testing,” not otherwise defined | Pts with TP53 mut clearance before allo-HCT did not experience DFS benefit |
DFS, disease-free survival; mut, mutation; NGS, next-generation sequencing; pts, patients; VAF, variant allele frequency; mut, mutation
Dillon et al performed genomic testing on pretransplant samples from the BMT-CTN 0910 RCT of myeloablative conditioning vs RIC for patients with AML and MDS.
Versluis et al performed genomic testing on pretransplant samples from BMT-CTN 11012 biologic assignment trial based on matched donor availability in older adults with higher-risk MDS who were candidates for allo-HCT.