biostudies-literatureLu XCAMS Innovation Fund for Medical ScienceBeijing Research Ward Excellence ProgramPeking University People's Hospital Scientific Research Development Fundsthe Grants from the Beijing Municipal Science and Technology Commissionthe Grants from the NSFC180https://www.ebi.ac.uk/biostudies/studies/S-EPMC12839384biostudies-literatureUnknown14(1)<b>Background</b>: The International Consensus Classification (ICC) currently proposes an empirical variant allele frequency (VAF) threshold of 10% to define TP53-mutated acute myeloid leukemia (AML) and to distinguish oncogenic driver from concomitant mutations. However, the optimal cutoff remains uncertain, and the biological and clinical features of low-VAF cases have not been systematically characterized. <b>Methods</b>: In this single-center retrospective cohort study, we stratified TP53-mutated AML by a 10% VAF cutoff and compared clinical characteristics, cytogenetic and molecular profiles, and survival outcomes between groups. <b>Results</b>: The VAF < 10% group exhibited a distinctive profile: fewer adverse cytogenetic abnormalities [complex karyotype, -7, -5/del(5q)], a more adveBiomedicinesLow-VAF TP53-Mutated AML Displays Distinct Biological Features in a Single-Center Cohort.PMC12839384CIFMS, 2023-I2M-C&T-B-123BRWEP, BRWEP2024W134080100RDL2023-08No. 62331025No. Z221100007422008Zhang KLu XJiang HHuang XMa XWei FJiang QZhang SChang YZhao XfalseLow-VAF TP53-Mutated AML Displays Distinct Biological Features in a Single-Center Cohort.<b>Background</b>: The International Consensus Classification (ICC) currently proposes an empirical variant allele frequency (VAF) threshold of 10% to define TP53-mutated acute myeloid leukemia (AML) and to distinguish oncogenic driver from concomitant mutations. However, the optimal cutoff remains uncertain, and the biological and clinical features of low-VAF cases have not been systematically characterized. <b>Methods</b>: In this single-center retrospective cohort study, we stratified TP53-mutated AML by a 10% VAF cutoff and compared clinical characteristics, cytogenetic and molecular profiles, and survival outcomes between groups. <b>Results</b>: The VAF < 10% group exhibited a distinctive profile: fewer adverse cytogenetic abnormalities [complex karyotype, -7, -5/del(5q)], a more adve2026-01-01T00:00:00Z2026 Jan2026-06-09T03:20:05.006Z2026-06-09T03:11:58.746ZS-EPMC128393844159571410.3390/biomedicines14010180