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December 8, 2025Blood

Prognostic impact of TP53 mutation status and variant allele frequency in myelodysplastic syndromes: A meta-analysis of prognosis and transplant outcomes

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Authors

DPDaniel Park

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Overview

Meta-analysis reveals TP53 mutation status predicts survival in myelodysplastic syndromes and patients post-transplant, suggesting the role of variant allele frequency in risk assessment.

Key Points

  • This research aims to evaluate the prognostic impact of TP53 mutation status and variant allele frequency in myelodysplastic syndromes (MDS), including post-transplant outcomes.
  • Conducted a meta-analysis examining prognostic implications of TP53 mutation status and VAF in MDS.
  • Included 33 studies reporting hazard ratios (HRs) for overall survival stratified by TP53 status and VAF thresholds.
  • Performed four primary analyses comparing overall survival between TP53-mutated patients and wild-type, with stratifications based on VAF and transplant outcomes.
  • Used random-effects model with inverse-variance weighting for pooled HRs and assessed heterogeneity using I² statistic.
  • Patients with any TP53 mutation showed significantly inferior overall survival compared to wild-type, with pooled HR of 2.34.
  • Single-hit mutations had HR: 1.59, while multi-hit mutations showed HR: 1.53 for overall survival.
  • High variant allele frequency (≥30%) was linked to significantly reduced overall survival (HR: 2.16) compared to low VAF (<30%) (HR: 1.60).
  • Among transplant recipients, TP53-mutated patients had worse post-transplant survival (HR: 1.99) compared to wild-type.

Cite This Study

Daniel Park (2025) studied this question.

synapsesocial.com/papers/69362f484fa91c937236d6a4https://doi.org/10.1182/blood-2025-7393
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative outcome and prognostic factor analysis among MDS/AML patients with TP53 mutations, snps, and wild type2025 · 4 citations
  2. 2<i>TP53</i> variant allele frequency as a driver of survival in <i>TP53</i> -mutated acute myeloid leukemia.2026
  3. 3Clinical implications of TP53 mutations (TP53MT) in patients (pts) with higher risk Myelodysplastic Syndromes (HR-MDS) treated with hypomethylating agents (HMA) and allogeneic hematopoietic transplantation (allo-HCT): An analysis from the international consortium of MDS (icMDS) validate database2025
  4. 4Functional classification of monoallelic TP53 mutations refines prognostic stratification in myelodysplastic neoplasms2025
  5. 5The prognostic impact of myeloid co-mutation burden in TP53-mutated AML/MDS after allogeneic stem cell transplantation: a multicenter retrospective analysis2026 · 3 citations