Research

Intervention: Prophylactic DLI after withdrawal of immune suppression to enhance the GvL effect in transplant-eligible patients with TP53 mutated myeloid neoplasms

Patient Selection:

1. Age: 18 or above (no upper limit)
2. Primary diagnosis of MDS, AML or MDS/AML as per ICC 2022 or MDS, MDS-IB, AML as per WHO 2022 including those who have antecedent MDS, MPN/MDS or CMML with

TP53 mutation of any variant allele frequency (VAF) detectable via Next Generation Sequencing

3. Patients must be in complete remission at the time of allograft (defined as <5% blasts by morphology)
4. Fit for allograft as per the treating centre

Referral: Patient should be advised of this initiative on referral for stem cell transplantation for TP53 mutated myeloid disorders

• Donor availability should be reviewed- this initiative will only be applicable for those patients who have:
  • Matched sibling donors
  • Matched unrelated donors
  • Mismatched unrelated donors – 7/8 donors are permitted with use of PTCy for GvHD prophylaxis
  • Haploidentical donors

Where DLI will be available

Prior treatment to allograft will be as per physician choice and as appropriate for clinical situation

Please can the TP53-DLI team be notified of each patient who proceeds with the protocol: [email protected]