{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T03:43:05Z","timestamp":1786592585573,"version":"build-2736575974"},"reference-count":10,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2025,6,15]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    We investigated the prognostic impact of blast counts,\n                    <jats:italic>TP53<\/jats:italic>\n                    allelic state determinants (number of hits, del(17p), variant allele frequency, complex karyotype),and a novel karyotypic clonal cell fraction (\u226450% clonal cells vs &gt;50% clonal cells (termed \u2018CK50\u2019)) in 495 individuals with\n                    <jats:italic>TP53-<\/jats:italic>\n                    mutated (\n                    <jats:italic>\n                      TP53\n                      <jats:sup>MUT<\/jats:sup>\n                    <\/jats:italic>\n                    ) 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%\u201319% blasts) and 71% (351\/495) AML (\u226520% blasts), with 18% (81\/460) having low CK50. Overall, 83% received front-line hypomethylating agents. Higher blast counts (&lt;20%\u2009vs \u226520%) 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\n                    <jats:italic>TP53<\/jats:italic>\n                    allelic state determinants, only CK50 and complex karyotype remained relevant for predicting adverse outcomes.\n                  <\/jats:p>","DOI":"10.1136\/jcp-2024-209954","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T13:20:19Z","timestamp":1750944019000},"page":"629-635","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Karyotypic clonal fraction predicts adverse outcome in\n                    <i>TP53<\/i>\n                    -mutated myeloid neoplasms: an International\n                    <i>TP53<\/i>\n                    investigators Network (iTiN) study"],"prefix":"10.1136","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5607-2096","authenticated-orcid":false,"given":"Madhavi","family":"Pandiri","sequence":"first","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Stengel","sequence":"additional","affiliation":[{"name":"MLL - Munich Leukemia Laboratory, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Children's Hospital of Colorado), UC Health University of Colorado Hospital, Anschutz Medical Campus, Aurora, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Wang","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haipeng","family":"Shao","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Medicine (Hematology Oncology), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinthujaa","family":"Velmurugan","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Jacob","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Symes","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandeep","family":"Kaur","sequence":"additional","affiliation":[{"name":"Pathology (Molecular Pathology), Endeavor Health Northshore Hospital, Evanston, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Rojek","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payal","family":"Sojitra","sequence":"additional","affiliation":[{"name":"Pathology, Rutgers, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danica","family":"Wiredja","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Children's Hospital of Colorado), UC Health University of Colorado Hospital, Anschutz Medical Campus, Aurora, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7483-0478","authenticated-orcid":false,"given":"Qianghua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology (Hematopathology), Laboratory Hematology (Laboratory Medicine Program), University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Chang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology (Hematopathology), Laboratory Hematology (Laboratory Medicine Program), University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esha","family":"Patil","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay L.","family":"Patel","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Internal Medicine (Hematology and Hematological Malignancies), The University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami B.","family":"Patel","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Internal Medicine (Hematology and Hematological Malignancies), The University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu","family":"Menon","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Internal Medicine (Hematology and Hematological Malignancies), The University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmila","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey D.","family":"Wool","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Arber","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenggang","family":"Pan","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Children's Hospital of Colorado), UC Health University of Colorado Hospital, Anschutz Medical Campus, Aurora, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Findley","sequence":"additional","affiliation":[{"name":"Medicine (Internal Medicine & Hematology- Oncology), Mayo Clinic, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talha","family":"Badar","sequence":"additional","affiliation":[{"name":"Medicine (Internal Medicine & Hematology- Oncology), Mayo Clinic, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Tariq","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sallman","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology), Medicine (Hematology Oncology), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C","family":"Bell","sequence":"additional","affiliation":[{"name":"Pathology (Division of Genomic Pathology & Hematopathology), University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamarija","family":"Perry","sequence":"additional","affiliation":[{"name":"Pathology (Division of Genomic Pathology & Hematopathology), University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Haferlach","sequence":"additional","affiliation":[{"name":"MLL - Munich Leukemia Laboratory, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8674-2608","authenticated-orcid":false,"given":"Girish","family":"Venkataraman","sequence":"additional","affiliation":[{"name":"Pathology (Hematopathology & Cancer Cytogenetics), Medicine (Hematology\/Oncology), The University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"2025121402524421000_78.9.629.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"2025121402524421000_78.9.629.2","doi-asserted-by":"publisher","DOI":"10.1182\/BLOOD.2022015850"},{"key":"2025121402524421000_78.9.629.3","doi-asserted-by":"publisher","DOI":"10.1182\/blood2022016867"},{"key":"2025121402524421000_78.9.629.4","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023010312"},{"key":"2025121402524421000_78.9.629.5","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-024-01077-9"},{"key":"2025121402524421000_78.9.629.6","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19895"},{"key":"2025121402524421000_78.9.629.7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-08-733196"},{"key":"2025121402524421000_78.9.629.8","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1203"},{"key":"2025121402524421000_78.9.629.9","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021014472"},{"key":"2025121402524421000_78.9.629.10","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1182\/blood.2024025409","article-title":"Genetic risk classification for adults with AML receiving less-intensive therapies: the 2024 ELN recommendations","volume":"144","author":"D\u00f6hner","year":"2024","journal-title":"Blood"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp-2024-209954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T10:52:55Z","timestamp":1765709575000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp-2024-209954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,8,18]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/jcp-2024-209954"],"URL":"https:\/\/doi.org\/10.1136\/jcp-2024-209954","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]}}}