Recommendations for Treating Patients With TP53-Mutated AML or MDS

Melhem Solh, MD, medical director for the Cellular Therapy Program at Northside Hospital, discusses what he is excited to see in the future for patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) that harbors a TP53 gene mutation, gives his own recommendations to community oncologists who are treating patients with this disease.

Solh presented data on a group of patients who had AML or high-risk MDS with a TP53 mutation who also underwent an allogeneic hematopoietic stem cell transplant at the 2022 Transplantation & Cellular Therapy Meetings

Data from his research showed that match-related donors were inferior to other groups of donors and about a third of patients with TP53 mutations could be saved by getting a transplant. Among patients, the 3-year overall survival was 29%. Further research is warranted to gain more of an understanding on how to best treat this patient population.

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0:08 | With this specific population of patients, definitely the newer leukemia therapies that we have going on, another study for bispecifics, the natural killer cell treatment, and the chimeric antigen receptor T-cell therapy. It will be very interesting to see how we incorporate these types of therapy into transplant, pre or post, to help improve the outcome of this patient.

0:33 | It is very important with acute leukemias to be in touch with a tertiary center from the time of diagnosis, because with acute leukemia, getting these patients into donor typing and donor search and getting them to transplant in a timely fashion is very important. I can't stress that enough. Especially with a TP53 del(17p), admission might be short, and you don't want to be delaying that. A quick referral to a transplant center is definitely helpful.

1:03 | And 2, be sure that you are sending the markers of acute leukemia, as you're checking the chromosomes [and] next-generation sequencing to have all that data available at time of diagnosis, because that will help the transplant center make the best decisions and [know] how to proceed with those patients.