TP53 mutations occur in 15.7% of ALL and are associated with MYC-rearrangement, low hypodiploidy, and a poor prognosis.
TP53 is the most extensively studied gene in cancer. However, data on frequency and the prognostic impact of TP53 mutations in acute lymphoblastic leukemia (ALL) remain scarce. Thus, we aimed at identifying the mutation frequency of TP53, its association with cytogenetic subgroups, and its impact on survival in a large cohort of 625 patients with ALL. Our data revealed an overall mutation incidence of 15.7%, which increases with age. Correlation with cytogenetic subgroups showed that mutations were most frequent in ALL with low hypodiploidy or MYC-rearrangements. Furthermore, for a large number of patients, both TP53 alleles were altered, either by 2 TP53 mutations (12%) or by a TP53 mutation and a TP53 deletion in the second allele (39%). A high TP53 mutation load was correlated to low hypodiploidy, high hyperdiploidy, and a complex karyotype. Moreover, a higher mutation load was found in B-lineage ALL compared with T-lineage ALL. Similar to other cancers, the median overall survival was significantly shorter in patients with TP53 mutation compared with patients with wild-type TP53. This effect was especially pronounced when both TP53 alleles were affected, either by 2 TP53 mutations or by both a mutation and an accompanying TP53 deletion.
Munich Leukemia Laboratory, Munich, Germany.
Anna
A
Stengel
Munich Leukemia Laboratory, Munich, Germany.
Susanne
S
Schnittger
Munich Leukemia Laboratory, Munich, Germany.
Sandra
S
Weissmann
Munich Leukemia Laboratory, Munich, Germany.
Sabrina
S
Kuznia
Munich Leukemia Laboratory, Munich, Germany.
Wolfgang
W
Kern
Munich Leukemia Laboratory, Munich, Germany.
Alexander
A
Kohlmann
Munich Leukemia Laboratory, Munich, Germany.
Torsten
T
Haferlach
Munich Leukemia Laboratory, Munich, Germany.
Claudia
C
Haferlach
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005787:Gene Frequency; D016259:Genes, myc / Q000235:genetics; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011003:Ploidies; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000401:mortality*; D011379:Prognosis; D014178:Translocation, Genetic; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*; D055815:Young Adult
C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53