Toop, Carla
Mayo Clinic
Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia.
Citations 2
RAS mutation identifies a poor prognostic molecular subtype of therapy-related myeloid neoplasm
Kok, Chung Hoow , Al‐Kali, Aref , He, Rong , Lim, Kelly , Saliba, Antoine N. , Toop, Carla , Matin, Aasiya , Gangat, Naseema , Mangaonkar, Abhishek A. , Hahn, Christopher N , Begna, Kebede H. , Hung, Kevin , Patnaik, Mrinal M. , Hiwase, Devendra , Saliba, Antoine N. , He, Rong , Kutyna, Monika M , Lim, Kelly , Saliba, Antoine N , Toop, Carla , Matin, Aasiya , Scott, Hamish , Gangat, Naseema , Brown, Anna L , Hahn, Christopher , Begna, Kebede , Hung, Kevin , Greipp, Patricia T , Hogan, William J , Patnaik, Mrinal , Shah, Mithun V , Hiwase, Devendra , Saliba, Antoine N , Kok, Chung H , THOMAS, DANIEL W. , Kutyna, Monika , Alkhateeb, Hassan B. , Scott, Hamish S. , Brown, Anna , Greipp, Patricia T. , Hogan, William J. , Shah, Meera
Blood Advances | May 22, 2025 | Volume: 9 | Issue: 15 | Pages: 3814-3818
Evidence-based risk stratification of myeloid neoplasms harboring TP53 mutations
Shah, Meera , Hung, Kevin , Baranwal, Anmol , Al‐Kali, Aref , Toop, Carla , Greipp, Patricia T. , Brown, Anna , Shah, Syed Naseem, Khanna, Shreyas, Ladon, Dariusz, Gannamani, Vedavyas, Begna, Kebede H. , Price, Zoe, Rud, Danielle, Litzow, Mark R. , Bardy, Peter, Badar, Talha , Kumar, Sharad , Patnaik, Mrinal M. , Foran, James M. , He, Rong , Gangat, Naseema , Scott, Hamish S. , Mangaonkar, Abhishek A. , Hahn, Christopher N , Tefferi, Ayalew , Hiwase, Devendra , Shah, Mithun V , Kutyna, Monika M , Al-Kali, Aref , Toop, Carla , Greipp, Patricia T , Brown, Anna L , Begna, Kebede , Litzow, Mark R. , Hogan, William J , Badar, Talha , Kumar, Sharad , Patnaik, Mrinal , He, Rong , Gangat, Naseema , Scott, Hamish , Arana Yi, Cecilia , Hahn, Christopher , Arber, Daniel A , Kok, Chung H , Hiwase, Devendra , Baranwal, Anmol , Hung, Kevin , Kutyna, Monika , Chen, Dong , Price, Zoe K. , Hogan, William J. , Yeung, David , Yi, Cecilia Arana , Alkhateeb, Hassan B. , THOMAS, DANIEL W. , Orazi, Attilio , Arber, Daniel A. , Kok, Chung Hoow
Blood Advances | March 14, 2025 | Volume: 9 | Issue: 13 | Pages: 3370-3380
10.1182/bloodadvances.2024015238
Abstract This retrospective analysis aimed to provide evidence-based risk stratification of TP53-mutated (TP53mut) myeloid neoplasms (MNs). Of 580 MNs harboring TP53mut with variant allele frequency (VAF) ≥2%, 219 (37.8%), 194 (33.4%), 92 (15.9%), and 75 (12.9%) were classified as acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) with low blasts (MDS-LB), MDS with excess blasts (MDS-EB)-2, and -EB1 according to the revised fourth edition of the World Health Organization (WHO) classification, respectively. Hierarchical analysis identified the following 4 risk groups with distinct survival: (1) MDS-LB, (2) MDS-EB1/EB2/AML VAF <10%, (3) MDS-EB1/EB2 VAF ≥10%, and (4) AML VAF ≥10%. We next evaluated the impact of allelic status, VAF, and complex karyotype (CK). In our cohort, the significance of biallelic status was limited to MDS with <5% blasts and not for blasts 5% to 9%, as proposed by the International Consensus Classification (ICC), or 5% to 19%, as proposed by the fifth edition of the WHO (WHO-5). MDS-EB1 and -EB2 with VAF ≥10% had comparable survival (9.6 vs 7.2 months; P = .12), regardless of allelic status. Contrary to the ICC proposal, MDS-EB1/EB2 with VAF <10% and CK had poor survival compared with those without CK, comparable to MDS-EB1/EB2 with VAF ≥10% (5.6 vs 26.2 vs 6.3 months; P = .003). Survival of TP53mut AML was poor (median 3.9 months) regardless of allelic/CK status. Thus, using ICC or WHO-5 may underestimate prognosis of MDS with blasts 5% to 19% and 5% to 9%, respectively. Collectively, the hierarchical model acknowledges poor survival of 91.9% TP53mut MDS and AML compared with 36.5% and 80.7% by WHO-5 and ICC, respectively.