Can Allogeneic HSCT Be Curative for TP53-Mutated MCL?

Allogeneic hematopoietic stem cell transplantation (HSCT) “can be curative” in patients with mantle cell lymphoma (MCL), including those with TP53 mutations, according to a recent study.

Thomas Lew, MBBS, of the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, the Walter and Eliza Hall Institute of Medical Research, and the University of Melbourne in Australia, led the study.

Dr. Lew and colleagues conducted the study because patients with TP53-mutated disease “have poor outcomes with standard approaches.” The researchers previously reported that allogeneic HSCT “achieved durable remissions” in patients with MCL, but follow-up among patients with TP53 mutations was “limited.”

The overall cohort included 36 patients, with 13 patients having a TP53 mutation. The median follow-up for the entire cohort was 10.8 years, while it was 4.2 years for the subset of patients with mutated TP53.

The estimated 10-year overall survival (OS) rate was 56% for the overall cohort. The estimated four-year OS rate was 59% for the patients with mutated TP53. In the patients with TP53-mutated disease, no relapses were reported more than six months after allogeneic HSCT. However, survival after a post-transplant relapse was “poor,” with a median survival of 2.1 years, according to the researchers.

“These data confirm that [allogeneic HSCT] can be curative in MCL, including patients with TP53-mutated disease, and should be considered for earlier utilization in this subgroup for whom conventional chemoimmunotherapy is ineffective,” Dr. Lew and colleagues concluded.

References

Lew TE, Cliff ERS, Dickinson M, et al. Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in TP53-mutated disease. Leuk Lymphoma. 2023. doi:10.1080/10428194.2023.2241095