Citations 1
Karyotypic clonal fraction predicts adverse outcome in TP53 -mutated myeloid neoplasms: an International TP53 investigators Network (iTiN) study
Pandiri, M, Stengel, Anna , Shao, Haipeng , Velmurugan, S. , Jacob, Anisha, Symes, Emily , Kaur, Amandeep , Rojek, Alexandra E. , Sojitra, Payal , Wiredja, Danica , Chang, Hong , Patil, Esha, Patel, Jay , Patel, Ami B. , Pan, Zenggang , Findley, Anthony, Badar, Talha , Tariq, Hamza , Sallman, David A. , Bell, Robert , Perry, Anamarija M. , Fitzpatrick, Carrie , Pandiri, Madhavi , Zhou, Qianghua , Venkataraman, Girish , Badar, Talha , Rojek, Alexandra E , Zhang, Jingjing , Wang, Peng , Shao, Haipeng, Jacob, Anisha, Menon, Madhu P , Ghosh, Sharmila , Wool, Geoffrey D. , Arber, Daniel A. , Findley, Anthony, Haferlach, Claudia
Journal of Clinical Pathology | June 26, 2025 | Volume: 78 | Issue: 9 | Pages: 629-635
We investigated the prognostic impact of blast counts, TP53 allelic state determinants (number of hits, del(17p), variant allele frequency, complex karyotype),and a novel karyotypic clonal cell fraction (≤50% clonal cells vs >50% clonal cells (termed ‘CK50’)) in 495 individuals with TP53- mutated ( TP53 MUT ) myeloid neoplasms. Outcome examined was 24-month survival (OS24). The cohort (median age 71) included 29% (144/495) myelodysplastic syndromes (MDS)/MDS-acute myeloid leukaemia (AML) (1%–19% blasts) and 71% (351/495) AML (≥20% blasts), with 18% (81/460) having low CK50. Overall, 83% received front-line hypomethylating agents. Higher blast counts (<20% vs ≥20%) were marginally associated with CK50 (p=0.08). In the OS24 analysis, blast count showed a marginal association with OS24 (HR 1.3 (95% CI 1.0 to 1.6); p=0.07), while CK50 predicted significantly inferior outcomes (HR=1.7 (95% CI 1.2 to 2.3); p=0.002). In a multivariable model including all TP53 allelic state determinants, only CK50 and complex karyotype remained relevant for predicting adverse outcomes.