The impact of TP53 mutations on prognosis in aggressive B-NHL was investigated within the RICOVER-60 trial. TP53 mutations were present in 63 of 265 patients (23.8%). TP53 mutation was associated with higher LDH (65% vs. 37%; p<0.001), higher international prognostic index-Scores (IPI 4/5 27% vs. 12%; p=0.025), and B-symptoms (41% vs. 24%; p=0.011). Patients with TP53 mutation were less likely to obtain a complete remission CR/CRu (CR unconfirmed) 61.9% (mut) vs. 79.7% (wt) (p=0.007). TP53 mutations were associated with decreased event-free (EFS), progression-free (PFS), and overall survival (OS) (median observation time of 40.2 months): the 3 year EFS, PFS and OS were 42% (vs. 60%; p=0.012), 42% (vs. 67.5%; p<0.001) and 50% (vs. 76%; p<0.001) for the TP53 mutation group. TP53 mutations should be considered for risk models in DLBCL and strategies to improve outcome for patients with mutant TP53 must be developed.
Thorsten Zenz, MD
Molecular Therapy in Haematology and Oncology (G250), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ)
Im Neuenheimer Feld 460
69120 Heidelberg, Germany