TP53基因突变对Ph阴性急性B淋巴细胞白血病异基因造血干细胞移植疗效的影响

OBJECTIVE: To evaluate the association of TP53 mutations with the clinical outcomes of Ph-negative B-ALL following allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: Total 300 patients with Ph-negative B-ALL who underwent allo-HSCT at the Hebei Yanda Ludaopei Hospital from May 2012 to May 2017 were retrospectively analyzed; their clinical characteristics, TP53 gene mutation type, and association between TP53 mutations and transplantation outcomes, including leukemia-free survival (LFS), overall survival (OS), non-relapse mortality (NRM), relapse, and GVHD, were evaluated. RESULTS: Total 23 patients had TP53 mutations; all the TP53 mutations affected P53’DNA-binding domain. The 5-year-LFS, OS, and RI were 34.8% and 62.3% (P=0.001), 41.9% and 65.1% (P=0.020), and 47.8% and 14.8% (P=0.000), respectively, for TP53 mutations and wild-type TP53 patients. However, there were no significant differences in NRM and GVHD. Multivariate analysis showed that TP53 mutations remained adverse prognostic factors for LFS, OS, and RI after allo-HSCT. CONCLUSION: Some patients with TP53 mutations can achieve long-term survival with allo-HSCT. TP53 mutations are adverse prognostic factors for Ph-negative B-ALL patients who undergo allo-HSCT.