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17-06-2024 | Acute Myeloid Leukemia | Research

Do NPM1 and FLT3-ITD mutations modify prognosis in patients treated with non-intensive regimens?

Authors: E. U. Suárez, B. Boluda, E. Lavilla, M. Tormo, C. Botella, C. Gil, S. Vives, C. Rodríguez, J. Serrano, M. J. Sayas, P. Martínez-Sánchez, F. Ramos, T. Bernal, L. Algarra, J. M. Bergua-Burgues, J. A. Pérez-Simón, P. Herrera, M. Barrios, V. Noriega-Concepción, J. A. Raposo-Puglia, R. Ayala, E. Barragán, D. Martínez-Cuadrón, M. L. Amigo, J. L. López-Lorenzo, A. Lázaro-García, J. E. Guimaraes, M. Colorado, R. García-Boyero, B. De Rueda-Ciller, M. Foncillas-García, A. Hong, J. Labrador, J. M. Alonso-Dominguez, P. Montesinos, on behalf of the PETHEMA group

Published in: Annals of Hematology

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Abstract

FLT3-ITD and NPM1 mutations are key to defining the genetic risk profile of acute myeloid leukemia (AML). We aimed to assess the prognostic features of the FLT3-ITD and NPM1 mutations in old and/or unfit individuals with AML treated with non-intensive therapies in the era before azacitidine-venetoclax approbation. The results of various non-intensive regimens were also compared. We conducted a retrospective analysis that included patients treated with different non-intensive regimens, between 2007 and 2020 from PETHEMA AML registry. We compiled 707 patients with a median age of 74 years and median follow-up time of 37.7 months. FLT3-ITD patients (N = 98) showed a non-significant difference in overall survival (OS) compared to FLT3-ITD negative-patients (N = 608) (P = 0.17, median OS was 5 vs 7.3 months respectively). NPM1-mutated patients (N = 144) also showed a non-significant difference with NPM1 wild type (N = 519) patients (P = 0.25, median OS 7.2 vs 6.8 respectively). In the Cox regression analysis neither NPM1 nor FLT3-ITD nor age were significant prognostic variables for OS prediction. Abnormal karyotype and a high leukocyte count showed a statistically significant deleterious effect. Azacitidine also showed better survival compared to FLUGA (low dose cytarabine plus fludarabine). NPM1 and FLT3-ITD seem to lack prognostic value in older/unfit AML patients treated with non-intensive regimens other than azacitidine-venetoclax combination.
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Metadata
Title
Do NPM1 and FLT3-ITD mutations modify prognosis in patients treated with non-intensive regimens?
Authors
E. U. Suárez
B. Boluda
E. Lavilla
M. Tormo
C. Botella
C. Gil
S. Vives
C. Rodríguez
J. Serrano
M. J. Sayas
P. Martínez-Sánchez
F. Ramos
T. Bernal
L. Algarra
J. M. Bergua-Burgues
J. A. Pérez-Simón
P. Herrera
M. Barrios
V. Noriega-Concepción
J. A. Raposo-Puglia
R. Ayala
E. Barragán
D. Martínez-Cuadrón
M. L. Amigo
J. L. López-Lorenzo
A. Lázaro-García
J. E. Guimaraes
M. Colorado
R. García-Boyero
B. De Rueda-Ciller
M. Foncillas-García
A. Hong
J. Labrador
J. M. Alonso-Dominguez
P. Montesinos
on behalf of the PETHEMA group
Publication date
17-06-2024
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-024-05840-7
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