TP53 mutations in myelodysplastic syndromes (MDS) were found to adversely affect prognosis. However, there are only a few reports on the significance of the expression of the p53 protein. We assessed p53 immunoreactivity (p53-IR) on bone marrow biopsies (BMBs) of patients with MDS that underwent bone marrow transplantation (BMT) to verify the association with clinical and histopathological data and outcome. Eighteen patients with MDS (5 refractory cytopenia with multilineage dysplasia and 13 RAEB2) were studied. There were 6 females and 12 males (mean age 50.5 years). All patients underwent allogeneic BMT. On sections from formalin-fixed, paraffin embedded BMBs at diagnosis, p53-IR was assessed as the percentage of hematopoietic cells showing intense nuclear staining (p53++). The mean percentage of p53++ cells for the whole series was 10.04% (median 4.05; range 0.5-52%). p53-IR was higher in females than in males, in RAEB2 than in RCMD, in BMBs with diffuse than in those with focal fibrosis (p=0.04) and was directly correlated with age (p=0.04). Using a cut-off value of 5%, p53-IR was significantly associated with overall survival: at 6 year follow up, 70% of patients with low p53-IR were alive, while none of those with higher p53-IR was (p=0.03). With the limitation due to the small number of cases, our results indicate that a high p53-IR at diagnosis is associated with clinically more aggressive MDS subtypes and with adverse histological prognostic factors, such as BM fibrosis. In addition, the significant correlation between p53 expression and OS found even in a small group of patients treated with BMT, confirms that p53-IR on BMBs could be a very strong parameter for the prognostic assessment of patients with MDS and should be introduced in the histopathological work-up of these diseases.
Prognostic value of p53 protein expression in bone marrow biopsies of patients with myelodysplastic syndromes that underwent bone marrow transplantation
PICH, Achille;
2014-01-01
Abstract
TP53 mutations in myelodysplastic syndromes (MDS) were found to adversely affect prognosis. However, there are only a few reports on the significance of the expression of the p53 protein. We assessed p53 immunoreactivity (p53-IR) on bone marrow biopsies (BMBs) of patients with MDS that underwent bone marrow transplantation (BMT) to verify the association with clinical and histopathological data and outcome. Eighteen patients with MDS (5 refractory cytopenia with multilineage dysplasia and 13 RAEB2) were studied. There were 6 females and 12 males (mean age 50.5 years). All patients underwent allogeneic BMT. On sections from formalin-fixed, paraffin embedded BMBs at diagnosis, p53-IR was assessed as the percentage of hematopoietic cells showing intense nuclear staining (p53++). The mean percentage of p53++ cells for the whole series was 10.04% (median 4.05; range 0.5-52%). p53-IR was higher in females than in males, in RAEB2 than in RCMD, in BMBs with diffuse than in those with focal fibrosis (p=0.04) and was directly correlated with age (p=0.04). Using a cut-off value of 5%, p53-IR was significantly associated with overall survival: at 6 year follow up, 70% of patients with low p53-IR were alive, while none of those with higher p53-IR was (p=0.03). With the limitation due to the small number of cases, our results indicate that a high p53-IR at diagnosis is associated with clinically more aggressive MDS subtypes and with adverse histological prognostic factors, such as BM fibrosis. In addition, the significant correlation between p53 expression and OS found even in a small group of patients treated with BMT, confirms that p53-IR on BMBs could be a very strong parameter for the prognostic assessment of patients with MDS and should be introduced in the histopathological work-up of these diseases.
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