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TP53 Mutation Indicates Poor Prognosis in Leukemia

These patients do not respond as well to F-based chemo for chronic lymphocytic leukemia

WEDNESDAY, Aug. 11 (HealthDay News) -- TP53 mutations are linked with poor prognosis in people with chronic lymphocytic leukemia (CLL), regardless of whether 17p deletion is present, according to research published online Aug. 9 in the Journal of Clinical Oncology.

Thorsten Zenz, M.D., of the University of Ulm in Germany, and colleagues assessed for TP53 mutations in 328 participants of a randomized prospective trial over more than four years to determine the prognostic impact of TP53 mutations in CLL. The patients had received fludarabine (F)-based chemotherapy.

The researchers found TP53 mutations in 28 (8.5 percent) of the subjects, none of whom showed a complete response to chemotherapy. Median progression-free survival (PFS) and overall survival (OS) were significantly lower in patients with TP53 mutation compared with those who did not have TP53 mutation (23.3 versus 62.2 months, respectively, and 29.2 versus 84.6 months, respectively). PFS and OS were similar in patients with TP53 mutations in the absence of 17p deletion -- found in 4.5 percent of patients -- and in the presence of 17p deletion. TP53 mutation was determined by further analysis as the strongest prognostic marker for PFS.

"CLL with TP53 mutation carries a poor prognosis regardless of the presence of 17p deletion when treated with F-based chemotherapy. Thus, TP53 mutation analysis should be incorporated into the evaluation of patients with CLL before treatment initiation. Patients with TP53 mutation should be considered for alternative treatment approaches," the authors write.

Two authors disclosed financial ties to Bayer Schering Pharma.

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