TP53 overexpression is an independent adverse prognostic factor in de novo myelodysplastic syndromes with fibrosis

Sanam Loghavi, Alyaa Al-Ibraheemi, Zhuang Zuo, Guillermo Garcia-Manero, Mariko Yabe, Sa A. Wang, Hagop M. Kantarjian, Cameron C. Yin, Roberto N. Miranda, Raja Luthra, L. Jeffrey Medeiros, Carlos E. Bueso-Ramos, Joseph D. Khoury

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Bone marrow (BM) fibrosis is associated with poor prognosis in patients with de novo myelodysplastic syndromes (MDS). TP53 mutations and TP53 (p53) overexpression in MDS are also associated with poor patient outcomes. The prevalence and significance of TP53 mutations and TP53 overexpression in MDS with fibrosis are unknown. We studied 67 patients with de novo MDS demonstrating moderate to severe reticulin fibrosis (MDS-F). Expression of TP53 was evaluated in BM core biopsy specimens using dual-colour CD34/TP53 immunohistochemistry with computer-assisted image analysis. Mutation analysis was performed using next-generation sequencing, or Sanger sequencing methods. TP53 mutations were present in 47·1% of cases. TP53 mutation was significantly associated with TP53 expression (P = 0·0294). High levels of TP53 expression (3 + in ≥10% cells) were associated with higher BM blast counts (P = 0·0149); alterations of chromosomes 5 (P = 0·0009) or 7 (P = 0·0141); complex karyotype (P = 0·0002); high- and very-high risk IPSS-R groups (P = 0·009); and TP53 mutations (P = 0·0003). High TP53 expression independently predicted shorter overall survival (OS) by multivariate analysis (P = <0·001). Expression of TP53 by CD34-positive cells was associated with shorter OS and leukaemia-free survival (P = 0·0428). TP53 overexpression is a predictor of poor outcome in patients with MDS-F.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalBritish Journal of Haematology
Volume171
Issue number1
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Keywords

  • Fibrosis
  • Myelodysplastic syndrome
  • Next-generation sequencing
  • TP53
  • TP53 expression

ASJC Scopus subject areas

  • Hematology

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