Talha Badar: Different aspects of TP53 mutated AML

1.  Impact of induction strategy on outcome 10.1002/ajh.26546
2.  Transplant outcome 10.1038/s41375-023-01847-7
3.  Racial disparities in treatment and outcomes 10.1002/cncr.34604
4.  Impact of venetoclax addition to HMA on response and survival 10.1038/s41408-024-01000-2
5.  Impact of ‘single’ vs ‘multi-hit’ TP53 10.3324/haematol.2024.285000

I can not thank enough to all the collaborators of Command Consortium.

Impact of induction strategy on outcome We saw increased utilization of venetoclax based therapy in recent times. In terms of induction strategy, HMA+VEN showed favorable odd ratio in achieving response but had higher TRM. Median EFS and OS remains dismal in the range of 6-9 months. 10.1002/ajh.26546

Transplant outcome.

Only 68/370 (18%) of patient were successfully bridge to allo-HCT. EFS and OS from time to allo-HCT was 12.4 and 24.5 mo

MRD/ TP53m status at alloHCT, intensity of conditioning was not predictive of outcome. Patient maintaining CR at D100 post alloHCT, occurrence of cGVHD suggestive of better outcome. 10.1038/s41375-023-01847-7

Racial disparities in treatment and outcomes

Non-Hispanic black (NHB) had higher incidence of t-AML, co-mutations. While responses were comparable, NHB less likely to receive curative intent therapies including alloHCT; highlighting disparities in treatment of TP53m/high-risk AML. 10.1002/cncr.34604

Impact of venetoclax addition to HMA on response and survival

1. We observed high CR rates (35% vs. 18%)
2. Extended DOR (15.6 vs. 7.93 months)
3. high % of patient progressing toward allo-HCT (13% vs. 4%) with HMA + VEN compared to HMA, this did not translate in an improvement in OS.

Baseline characteristics, co-mutation patterns, or the presence of complex CG and MH TP53m comparable b/w 2 gps. 10.1038/s41408-024-01000-2

Impact of ‘single’ vs ‘multi-hit’ TP53 Unlike low risk MDS we didn’t find differential impact on response and outcome b/w SH vs MH TP53 DOR, EFS and OS were comparable b/w SH and MH TP53

Allo-HCT associated with improve survival irrespective of mutation status. 10.3324/haematol.2024.285000

Source: Talha Badar/X

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