[Biological and clinical significance of TP53 mutations in myelodysplastic syndrome and acute myeloid leukemia]

Rinsho Ketsueki. 2023;64(9):955-961. doi: 10.11406/rinketsu.64.955.
[Article in Japanese]

Abstract

Anthracycline- and cytarabine-based intensive combination chemotherapies are considered the backbone therapy for patients with acute myeloid leukemia (AML). Although chemotherapy leads to long-term remission and cures many patients with AML, it can induce DNA damage/stress due to acute/chronic toxicities, acquired resistance, relapse, and therapy-related malignancies. Introduction of molecularly targeted agents with less systemic toxicities has considerably improved the scope of treatment, particularly in elderly and frail patients. However, outcomes of TP53-mutated myelodysplastic syndrome (MDS) and AML, a distinct group of myeloid disorders, have not improved irrespective of the treatment used (median overall survival, 5-10 months). In this review, we discuss the biological and clinical significance of TP53 mutations in malignancies, while particularly focusing on MDS/AML, and emerging therapies for TP53-mutated MDS/AML. Rationally designed novel treatment strategies are expected to improve the clinical outcomes of TP53-mutated MDS/AML.

Keywords: Acute myelogenous leukemia; Myelodysplastic syndrome; TP53 (p53).

Publication types

  • Review
  • English Abstract

MeSH terms

  • Aged
  • Antineoplastic Agents* / therapeutic use
  • Clinical Relevance
  • Humans
  • Leukemia, Myeloid, Acute* / drug therapy
  • Leukemia, Myeloid, Acute* / genetics
  • Leukemia, Myeloid, Acute* / pathology
  • Mutation
  • Myelodysplastic Syndromes* / drug therapy
  • Myelodysplastic Syndromes* / genetics
  • Tumor Suppressor Protein p53 / genetics

Substances

  • Antineoplastic Agents
  • Tumor Suppressor Protein p53
  • TP53 protein, human