How I Treat TP53-Mutated Acute Myeloid Leukemia and Myelodysplastic Syndromes
Abstract
:Simple Summary
Abstract
1. Introduction
2. Landscape of TP53 Mutations
3. TP53 Mutations in AML and MDS
4. Treatment of AML and MDS with TP53 Mutation by Intensive Chemotherapy
5. Hypomethylating Agents (HMA) Alone
6. HMA in Combination with Other Drugs in AML and MDS with TP53 Mutation
6.1. HMA + Venetoclax
6.2. Azacitidine + Eprenetapopt
6.3. Azacitidine + Magrolimab
6.4. AZA+ Sabatolimab
7. New Combinations Needing Investigation
8. Allogeneic Stem Cell Transplantation
9. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Regimen | Demographics | CR | EFS | OS | References |
---|---|---|---|---|---|
Cytarabine + anthracycline (7 + 3) and CPX 351 | 18–85 y/o | 28–48% | 3 years EFS 1–6% | 3 years OS 3–8% | [16,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] |
Regimen | Demographics | CR | EFS | OS | References |
---|---|---|---|---|---|
Azacitidine | 20–91 y/o | 20–40% | Not available | Median OS: 7 months | [34,35,36,41] |
Decitabine | 47–90 y/o | 30% | Median EFS: 6 months | Median OS: 2.1–7 months | [28,35,37,38,39,40] |
Regimen | Demographics | CR/CRi | EFS | OS | References |
---|---|---|---|---|---|
Azacitidine + venetoclax OR Decitabine + venetoclax | 22–86 y/o | 43–67% | Median EFS: 6–7 months | Median OS: 5–7 months | [42,43,44,45,46] |
Azacitidine + eprenetapopt | 34–87 y/o | 44% | Not available | Median OS: 11 months | [47,48] |
Azacitidine + magrolimab | Median age 72 y/o | 45% CR, 14% CRi | Not available | Median OS: 12.9 months | [49] |
Pathology | N | Conditioning | RFS | OS | NRM | Reference |
---|---|---|---|---|---|---|
AML (62%)/MDS (38%) with 17p abnormalities | 30 | RIC (63%)/MAC (37%) | Median RFS: 6 months (AML)–4 months (MDS) | Median OS: 18 months (AML)–11 months (MDS) | 9.1% (MDS)–10.6% (AML) | [67] |
AML with 17p abnormalities | 139 | RIC (59%)/MAC (41%) | 2 years LFS: 24% | 2 years OS: 28% | 2 years NRM: 15% | [68] |
TP53 mut MDS | 289 | RIC/MAC | Not available | 3 years OS: 20% Median OS: 8 months | 2 years NRM: 35% | [69] |
TP53 mut AML/MDS | 83 | RIC (29%)/MAC (79%) | 1 year PFS: 25% Median PFS: 5 months | 1 year OS: 35% Median OS: 8 months | 1 year NRM: 20% | [70] |
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Loschi, M.; Fenaux, P.; Cluzeau, T. How I Treat TP53-Mutated Acute Myeloid Leukemia and Myelodysplastic Syndromes. Cancers 2022, 14, 4519. https://doi.org/10.3390/cancers14184519
Loschi M, Fenaux P, Cluzeau T. How I Treat TP53-Mutated Acute Myeloid Leukemia and Myelodysplastic Syndromes. Cancers. 2022; 14(18):4519. https://doi.org/10.3390/cancers14184519
Chicago/Turabian StyleLoschi, Michael, Pierre Fenaux, and Thomas Cluzeau. 2022. "How I Treat TP53-Mutated Acute Myeloid Leukemia and Myelodysplastic Syndromes" Cancers 14, no. 18: 4519. https://doi.org/10.3390/cancers14184519