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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

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 (NPM1^mut). 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 NPM1^mut. 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 (NPM1^{A − type mut}) and non-A-type NPM1 mutations (NPM1^{non − A−type mut}). Event-free survival (EFS) was significantly different between patients with low NPM1^{non − A−type mut} variant allele frequency (VAF) and low NPM1^{A − type mut} VAF (median EFS = 3.9 vs. 8.5 months, P = 0.020). The median overall survival (OS) of the NPM1^{non − A−type mut}FLT3-ITD^mut group, the NPM1^{A − type mut}FLT3-ITD^mut group, the NPM1^{non − A−type mut}FLT3-ITD^wt group, and the NPM1^{A − type mut}FLT3-ITD^wt 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 NPM1^{A − type mut} and NPM1^{non − 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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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
Keyword: Acute Myeloid Leukemia
Published in: Annals of Hematology
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-024-05786-w

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