Tp53 Genetic Mutations in Chronic Lymphocytic Leukemia Patients in Iraq

Abstract BACKGROUND: Chronic lymphocytic leukemia (CLL) is a malignant clonal proliferative condition of mature CD5+ B cells, with a 4.2/100,000 annual incidence rate and the median age at diagnosis is 72 years. CLL impacts mainly the elderly in Western nations. About 4%–10% of patients have 17p deleted at diagnosis, which includes tumor-suppressor protein (TP53) gene deletions and/or mutations. However, TP53 can also be acquired during the course of the disease, with a predictable incidence of 42%–45% in refractory CLL. Even when this mutation develops in a small percentage of neoplastic cells, the attending of subclonal TP53 changes has been linked to a bad prognosis. TP53 mutations are correlated with significantly lower lifespan and indicate impaired tolerance to chemoimmunotherapy, making them among the most powerful prognostic markers-guiding treatment decisions in CLL. MATERIALS AND METHODS: This cross-sectional study was performed at different centers in Iraq, including Euphrates Center for Cancerous Tumors, Najaf, and the Hematology center-medical City, Baghdad, Imam al Hussien Medical City, Karbala, from October 2023 to June 2024, with patients diagnosed by blood film and immunophenotyping CLL, included 63 patients. RESULTS: DNA Sequencing of TP53 genes investigated by Sanger technique to detect TP53 variations. All potential genotype variations of the TP53 gene were detected across several single-nucleotide polymorphisms (SNPs). CONCLUSIONS: The vast majority, 93% of our patients, carry variant-type mutations of TP53. The genotype of SNP rs1597359353 was found P < 0.05, which is significant according to the White blood count (WBCs) count, although all patients on treatment or follow-up had TP53 mutations.