{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:17:25Z","timestamp":1788517045345,"version":"build-2803163510"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bone Marrow Transplant"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    TP53 mutations define a clinically distinct subset of acute myeloid leukaemia (AML) associated with complex cytogenetics and therapy resistance. We performed a retrospective single-centre analysis of 61 consecutive TP53-altered AML patients undergoing first allogeneic haematopoietic cell transplantation (allo-HCT) at the Medical Center Freiburg (2007\u20132025), compared with 636 TP53-wild-type controls. TP53-altered patients had markedly inferior overall survival (median 379 vs. 1694 days; 5-year OS 18% vs. 50%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Excess relapse was the primary driver (5-year cumulative incidence 55% vs. 33%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), whereas non-relapse mortality did not differ (28.5% vs. 23%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.426). On multivariable Cox analysis, TP53 alteration was the strongest independent predictor of inferior OS (HR 2.54, 95% CI 1.77\u20133.64;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and this association persisted after adjustment for cytogenetic risk and for the refined Disease Risk Index. In an exploratory hierarchical clustering analysis extended by seven patients from a second centre, two subgroups emerged: a del(17p)-enriched cluster (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200912; median OS 5.7 months) and a TP53 point mutation-enriched cluster (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200956; median OS 15.1 months). TP53-altered AML is confirmed as the strongest independent adverse prognostic factor after allo-HCT, and molecular heterogeneity within this subtype may inform trial stratification and targeted post-transplant interventions.\n                  <\/jats:p>","DOI":"10.1038\/s41409-026-03029-2","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:01:41Z","timestamp":1788516101000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterisation of TP53 mutational features and outcomes of acute myeloid leukaemia after allogeneic haematopoietic cell transplantation"],"prefix":"10.1038","author":[{"given":"Martina","family":"Reuss","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1868-2083","authenticated-orcid":false,"given":"Thomas","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Ingelfinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5197-453X","authenticated-orcid":false,"given":"Rouven","family":"Hoefflin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5304-8943","authenticated-orcid":false,"given":"Miriam Mozaffari","family":"Jovein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosna","family":"Baniadam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Pfeifer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7325-7753","authenticated-orcid":false,"given":"Justus","family":"Duyster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8287-5673","authenticated-orcid":false,"given":"Jesus","family":"Duque-Afonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-2807","authenticated-orcid":false,"given":"Kristina","family":"Maas-Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0813-3444","authenticated-orcid":false,"given":"Ralph","family":"W\u00e4sch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4861-7021","authenticated-orcid":false,"given":"Armin","family":"Zebisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5298-9880","authenticated-orcid":false,"given":"Annkristin","family":"Heine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Holderried","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1799-5927","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Finke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5037-6175","authenticated-orcid":false,"given":"Claudia","family":"Wehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-3393","authenticated-orcid":false,"given":"Robert","family":"Zeiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-7391","authenticated-orcid":false,"given":"Tobias","family":"Wertheimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"3029_CR1","doi-asserted-by":"publisher","unstructured":"Ley TJ, Miller C, Ding L, Raphael BJ, Mungall AJ. 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T.W. received a travel grant from Medac. C.W. received travel grants, honoraria or research support from Grifols, Jazz Pharmaceuticals, Takeda and MSD.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}