Overview of Acute Myeloid Leukemia with TP53 Mutation: Single Center, Real-Life Data

Objective: Acute myeloid leukemia (AML) with TP53 mutations represents a distinct and high-risk molecular subgroup characterized by aggressive disease progression, chemoresistance, and poor survival outcomes. This study provides a single-center analysis of clinical characteristics, treatment responses, and survival outcomes in a real-world cohort of patients with TP53-mutated AML. Material and Method: A retrospective observational study was conducted at Ankara Etlik City Hospital, analyzing nine patients diagnosed with TP53-mutated AML between January 2023 and January 2024. Patients were treated with intensive or less intensive induction regimens based on patient-related factors. Cytogenetic and molecular abnormalities were recorded, alongside treatment responses were assessed per the European Leukemia Net 2022 guidelines. The primary endpoint was overall survival. Results: The median age at diagnosis was 65 years, with 55.5% female patients. Complex karyotypes were observed in 66.7% of cases, and multi-hit TP53 mutations were identified in two patients. A complete response was achieved in 75% of patients treated with intensive induction therapy (7+3), while a complete or partial response was achieved in 60% of patients receiving the azacitidine-venetoclax regimen. Six patients died within 12 months, predominantly due to infection, while the three surviving patients underwent for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The median overall survival (OS) of the entire cohort was 9 months. Patients with TP53-mutated AML who underwent allo-HSCT exhibited significantly prolonged OS (p=0.01). Conclusion: The prognosisof TP53-mutated AML remains particularly poor, highlighting an urgent need for the development of novel therapeutic approaches to improve patient outcomes. While allo-HSCT offers a potential survival benefit, effective bridging therapies and post-transplant management are critical for improving outcomes in this high-risk population