Waldenström Macroglobulinemia: The Role of TP53 Mutations in Disease Progression and Therapeutic Response.

Waldenström Macroglobulinemia (WM) is a rare, indolent B-cell lymphoproliferative disorder characterized by the production of monoclonal IgM paraprotein and infiltration of the bone marrow by lymphoplasmacytic cells. While WM generally exhibits a slow clinical course, it has the potential to progress into more aggressive hematologic malignancies, such as diffuse large B-cell lymphoma. The gene, often referred to as the "guardian of the genome", plays a pivotal role in maintaining genomic stability, regulating the cell cycle, and orchestrating apoptosis. Mutations in undermine these essential processes, resulting in dysregulated cellular proliferation, defective apoptotic mechanisms, and genomic instability-hallmarks of cancer development. Although mutations have been extensively investigated in several hematologic malignancies, including acute myeloid leukemia, myelodysplastic syndromes, and chronic lymphocytic leukemia, their role in WM remains underexplored. Emerging evidence suggests that mutations may have a significant impact on the disease progression and therapeutic response in WM. This review examines the current knowledge of mutations in WM, highlighting their implications for prognosis and therapeutic strategies. A deeper understanding of the role of in WM could provide critical insights for improving disease management and advancing the development of targeted therapies.