{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:41:35Z","timestamp":1790948495746,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"ABSTRACT<\/jats:title>A total of 142 patients with myeloproliferative neoplasms (MPNs) or acute myeloid leukemia (AML) associated with multihit TP53<\/jats:italic> mutations (mTP53<\/jats:italic>\nMUT<\/jats:sup>) were accessed from the Mayo Clinic database and included (i) chronic phase MPN (MPN\u2010CP; N<\/jats:italic>\u2009=\u200919), (ii) accelerated phase MPN (MPN\u2010AP; N<\/jats:italic>\u2009=\u200914), (iii) blast phase MPN (MPN\u2010BP; N<\/jats:italic>\u2009=\u200928), and (iv) AML (N<\/jats:italic>\u2009=\u200981). Concurrent ASXL1<\/jats:italic>\nMUT<\/jats:sup>, EZH2<\/jats:italic>\nMUT<\/jats:sup>, IDH1<\/jats:italic>,MUT<\/jats:sup> and IDH2<\/jats:italic>\nMUT<\/jats:sup> were more common in MPN\u2010MUT<\/jats:sup>BP\u2010mTP53 compared to AML\u2010mTP53<\/jats:italic>\nMUT<\/jats:sup>. At median of 11.6\u2009months follow\u2010up, 124 (87%) deaths and 19 (13%) allogeneic stem cell transplantations (ASCT) were documented. Overall survival (OS), calculated from the time of mTP53<\/jats:italic>\nMUT<\/jats:sup> detection, was similar between MPN\u2010BP\u2010mTP53<\/jats:italic>\nMUT<\/jats:sup> (median 4.6\u2009months) and MPN\u2010AP\u2010mTP53<\/jats:italic>\nMUT<\/jats:sup> (5.6\u2009months; p<\/jats:italic>\u2009=\u20090.5) but both were inferior to MPN\u2010CP\u2010mTP53<\/jats:italic>\nMUT<\/jats:sup> (11.6\u2009months, p<\/jats:italic>\u2009<\u20090.01). OS in MPN\u2010CP\u2010mTP53<\/jats:italic>\nMUT<\/jats:sup> was similar to that of AML\u2010mTP53<\/jats:italic>\nMUT<\/jats:sup> (median 7.4\u2009months, p<\/jats:italic>\u2009=\u20090.07). In multivariable analysis, OS was favorably affected by ASCT (HR 0.4, p<\/jats:italic>\u2009=\u20090.03) and disease stage (i.e., chronic phase disease) or achieving response to pre\u2010transplant chemotherapy (HR 0.2, p<\/jats:italic>\u2009<\u20090.01) and unfavorably by the presence of concurrent TET2<\/jats:italic>\nMUT<\/jats:sup> or DNMT3A<\/jats:italic>\nMUT<\/jats:sup> (HR 2.7, p<\/jats:italic>\u2009<\u20090.01). Based on these risk factors, a 3\u2010tiered risk model was constructed: low (no risk factors; N<\/jats:italic>\u2009=\u200918; median OS 23.8\u2009months); intermediate (one risk factor; N<\/jats:italic>\u2009=\u200944; 11.1\u2009months); and high (two or more risk factors; N<\/jats:italic>\u2009=\u200980; 4\u2009months; p<\/jats:italic>\u2009<\u20090.01). The current study highlights the equally detrimental impact of mTP53<\/jats:italic>\nMUT<\/jats:sup> on long\u2010term survival in MPN and AML and identifies predictors of short\u2010term survival.<\/jats:p>","DOI":"10.1002\/ajh.27670","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T05:53:17Z","timestamp":1741845197000},"page":"1010-1018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Multihit TP53<\/i><\/scp> Mutations in Myeloproliferative Neoplasms and Acute Myeloid Leukemia: Comparative Analysis of Survival and Risk Factors in 142 Informative Cases"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9979-7923","authenticated-orcid":false,"given":"Saubia","family":"Fathima","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester Minnesota 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