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09-05-2024 | Acute Myeloid Leukemia | Original Article

Clinical prognostic value of different NPM1 mutations in acute myeloid leukemia patients

Authors: Yu Shi, Xiao Chen, Huimin Jin, Liying Zhu, Ming Hong, Yu Zhu, Yujie Wu, Hairong Qiu, Yan Wang, Qian Sun, Hui Jin, Jianyong Li, Sixuan Qian, Chun Qiao

Published in: Annals of Hematology | Issue 7/2024

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Abstract

Background: Acute myeloid leukemia (AML) patients with various nucleophosmin 1 (NPM1) mutations are controversial in the prognosis. This study aimed to investigate the prognosis of patients according to types of NPM1 mutations (NPM1mut). Methods: Bone marrow samples of 528 patients newly diagnosed with AML, were collected for morphology, immunology, cytogenetics, and molecular biology examinations. Gene mutations were detected by next-generation sequencing (NGS) technology. Results: About 25.2% of cases exhibited NPM1mut. 83.5% of cases were type A, while type B and D were respectively account for 2.3% and 3.0%. Furthermore, 15 cases of rare types were identified, of which 2 cases have not been reported. Clinical characteristics were similar between patients with A-type NPM1 mutations (NPM1A − type mut) and non-A-type NPM1 mutations (NPM1non  A−type mut). Event-free survival (EFS) was significantly different between patients with low NPM1non − A−type mut variant allele frequency (VAF) and low NPM1A − type mut VAF (median EFS = 3.9 vs. 8.5 months, P = 0.020). The median overall survival (OS) of the NPM1non − A−type mutFLT3-ITDmut group, the NPM1A − type mutFLT3-ITDmut group, the NPM1non − A−type mutFLT3-ITDwt group, and the NPM1A − type mutFLT3-ITDwt group were 3.9, 10.7, 17.3 and 18.8 months, while the median EFS of the corresponding groups was 1.4, 5.0, 7.6 and 9.2 months (P < 0.0001 and P = 0.004, respectively). Conclusions: No significant difference was observed in OS and EFS between patients with NPM1A − type mut and NPM1non − A−type mut. However, types of NPM1 mutations and the status of FLT3-ITD mutations may jointly have an impact on the prognosis of AML patients.
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Metadata
Title
Clinical prognostic value of different NPM1 mutations in acute myeloid leukemia patients
Authors
Yu Shi
Xiao Chen
Huimin Jin
Liying Zhu
Ming Hong
Yu Zhu
Yujie Wu
Hairong Qiu
Yan Wang
Qian Sun
Hui Jin
Jianyong Li
Sixuan Qian
Chun Qiao
Publication date
09-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 7/2024
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-024-05786-w

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