CLINICAL NEWS |
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Compared with patients without TP53 mutations , patients with TP53 mutations “ displayed highly aggressive baseline characteristics and were highly associated with blastoid morphology ( 12 % vs . 60 %; p < 0.0001 ), Ki67 ≥30 % ( 38 % vs . 79 %; p = 0.001 ), MIPI high-risk ( 15 % vs . 70 %; p < 0.001 ) and MIPI-c high-risk ( 9 % vs . 58 %; p < 0.001 ),” the investigators observed .
TP53 mutations were also associated with lower rates of complete remission
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after induction chemotherapy ( 71 % vs . 25 %; p = 0.0002 ) and AHCT ( 90 % vs . 45 %; p < 0.0001 ).
In an editorial accompanying the report , Jonathon B . Cohen , MD , MS , from Winship Cancer Institute at Emory University , commented that these findings “ contribute to the growing body of literature suggesting that available , aggressive induction therapies for MCL are highly effective for most , but not all ,
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patients with MCL .” 2 How to best manage these patients remains unknown , he continued , adding that “ the answer will most likely reside with novel approaches to therapy .” Until these approaches are identified , he concluded , “ assessing for TP53 aberrations should be considered a priority when only a limited panel of molecular assessments is feasible .”
The authors noted that the study ’ s findings may not be generalizable to
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patients treated with non-chemotherapeutic regimens .
Contributing authors report financial relationships with Celgene and Janssen .
REFERENCES
1 . Eskelund CW , Dahl C , Hansen JW , et al . TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy . Blood . 2017 August 17 . [ Epub ahead of print ]
2 . Cohen JB . TP53 mutations in MCL : more therapy is not better . Blood . 2017 August 17 . [ Epub ahead of print ]
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