{
  "abstract": "We investigated the prognostic impact of blast counts, TP53 allelic state determinants (number of hits, del(17p), variant allele frequency, complex karyotype),and a novel karyotypic clonal cell fraction (≤50% clonal cells vs >50% clonal cells (termed ‘CK50’)) in 495 individuals with TP53-mutated (TP53MUT ) myeloid neoplasms. Outcome examined was 24-month survival (OS24). The cohort (median age 71) included 29% (144/495) myelodysplastic syndromes (MDS)/MDS-acute myeloid leukaemia (AML) (1%–19% blasts) and 71% (351/495) AML (≥20% blasts), with 18% (81/460) having low CK50. Overall, 83% received front-line hypomethylating agents. Higher blast counts (<20% vs ≥20%) were marginally associated with CK50 (p=0.08). In the OS24 analysis, blast count showed a marginal association with OS24 (HR 1.3 (95% CI 1.0 to 1.6); p=0.07), while CK50 predicted significantly inferior outcomes (HR=1.7 (95% CI 1.2 to 2.3); p=0.002). In a multivariable model including all TP53 allelic state determinants, only CK50 and complex karyotype remained relevant for predicting adverse outcomes.",
  "authors": [
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Madhavi Pandiri"
    },
    {
      "affiliations": [
        "MLL - Munich Leukemia Laboratory, Munich, Germany"
      ],
      "name": "Anna Stengel"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Children's Hospital of Colorado), UC Health University of Colorado Hospital, Anschutz Medical Campus, Aurora, Colorado, USA"
      ],
      "name": "Jingjing Zhang"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Peng Wang"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Medicine (Hematology Oncology), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA"
      ],
      "name": "Haipeng Shao"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Sinthujaa Velmurugan"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Anisha Jacob"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Emily Symes"
    },
    {
      "affiliations": [
        "Pathology (Molecular Pathology), Endeavor Health Northshore Hospital, Evanston, Illinois, USA"
      ],
      "name": "Amandeep Kaur"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Alexandra Rojek"
    },
    {
      "affiliations": [
        "Pathology, Rutgers, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA"
      ],
      "name": "Payal Sojitra"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Children's Hospital of Colorado), UC Health University of Colorado Hospital, Anschutz Medical Campus, Aurora, Colorado, USA"
      ],
      "name": "Danica Wiredja"
    },
    {
      "affiliations": [
        "Laboratory Medicine and Pathobiology (Hematopathology), Laboratory Hematology (Laboratory Medicine Program), University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Qianghua Zhou"
    },
    {
      "affiliations": [
        "Laboratory Medicine and Pathobiology (Hematopathology), Laboratory Hematology (Laboratory Medicine Program), University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Hong Chang"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Esha Patil"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Internal Medicine (Hematology and Hematological Malignancies), The University of Utah School of Medicine, Salt Lake City, Utah, USA"
      ],
      "name": "Jay L. Patel"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Internal Medicine (Hematology and Hematological Malignancies), The University of Utah School of Medicine, Salt Lake City, Utah, USA"
      ],
      "name": "Ami B. Patel"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Internal Medicine (Hematology and Hematological Malignancies), The University of Utah School of Medicine, Salt Lake City, Utah, USA"
      ],
      "name": "Madhu Menon"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Henry Ford Health System, Detroit, Michigan, USA"
      ],
      "name": "Sharmila Ghosh"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Geoffrey D. Wool"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Daniel A. Arber"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Children's Hospital of Colorado), UC Health University of Colorado Hospital, Anschutz Medical Campus, Aurora, Colorado, USA"
      ],
      "name": "Zenggang Pan"
    },
    {
      "affiliations": [
        "Medicine (Internal Medicine & Hematology- Oncology), Mayo Clinic, Jacksonville, Florida, USA"
      ],
      "name": "Anthony Findley"
    },
    {
      "affiliations": [
        "Medicine (Internal Medicine & Hematology- Oncology), Mayo Clinic, Jacksonville, Florida, USA"
      ],
      "name": "Talha Badar"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"
      ],
      "name": "Hamza Tariq"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology), Medicine (Hematology Oncology), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA"
      ],
      "name": "David Sallman"
    },
    {
      "affiliations": [
        "Pathology (Division of Genomic Pathology & Hematopathology), University of Michigan, Ann Arbor, Michigan, USA"
      ],
      "name": "Robert C Bell"
    },
    {
      "affiliations": [
        "Pathology (Division of Genomic Pathology & Hematopathology), University of Michigan, Ann Arbor, Michigan, USA"
      ],
      "name": "Anamarija Perry"
    },
    {
      "affiliations": [
        "MLL - Munich Leukemia Laboratory, Munich, Germany"
      ],
      "name": "Claudia Haferlach"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Carrie Fitzpatrick"
    },
    {
      "affiliations": [
        "Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"
      ],
      "name": "Girish Venkataraman"
    }
  ],
  "title": "Karyotypic clonal fraction predicts adverse outcome in TP53-mutated myeloid neoplasms: an International TP53 investigators Network (iTiN) study",
  "uid": "af57fe65-b0a0-563e-add5-f518507e1632"
}