Outcomes with allogeneic hematopoietic stem cell transplantation in TP53-mutated acute myeloid leukemia: a systematic review and meta-analysis

Abstract

We conducted a systematic review and meta-analysis to evaluate outcomes after allogeneic hematopoietic stem cell transplantation (HSCT) in TP53-mutated acute myeloid leukemia (AML). We performed a literature search on PubMed, Embase, Cochrane Library, and ClinicalTrials.gov. After screening 592 manuscripts, eight studies were included. Data were extracted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pooled analysis was done using the meta-package by Schwarzer et al. Proportions with 95% confidence intervals (CIs) were computed. We analyzed 297 patients. The median follow-up was 45 (0.9–407.3) months. The pooled 2-year overall survival was 29.7% (95% CI 0.17–0.43, n = 82/248). The pooled relapse rate was 61.4% (95% CI 0.41–0.79, n = 139/247) at a median follow-up time of 2 (0.26–3) years. Three-year progression-free survival and non-relapse mortality were reported by one study as 7.5% and 32.5%, respectively. Outcomes of HSCT for TP53-mutated AML are poor; however, HSCT confers a survival advantage as compared to non-transplant palliative therapies.

Keywords:

• Acute myeloid leukemia
• TP53 mutation
• allogeneic hematopoietic stem cell transplantation
• outcomes

Disclosure statement

No relevant conflict of interest. SHA has speaking, consulting, and advisory role, and research funding from in Incyte and Therakos. JPM has speaking, consulting, and advisory role in Kite, Juno Therapeutics, Allovir, Magenta Therapeutics, EcoR1 Capital, and has research funding from Novartis, Fresenius Biotech, Astellas Pharma, Bellicum Pharmaceuticals, Gamida Cell, Pluristem Therapeutics, Kite, and AlloVir.