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Table 2 NPM1 Mutant Risk Assessment

From: Molecular prognostic markers for adult acute myeloid leukemia with normal cytogenetics

Study

Number of NPM1 mutants/total cases studied

Treatment

Demographics of those patients with NMP1 mutations

+ NPM1 mutant assessment of risk

Verhaak, et al [6]

95/275

(34.5%)

Dutch Belgian Hematology Oncology Cooperative Groop (HOVON) protocols

- Median age 47 yo

- 60% of those with FLT3 ITD

- decreased in those age < 35 yo

- 42% of those with WBC >20 K

HR

EFS 1.96

DFS 2.0

OS 2.13

Döhner, et al [14]

145/300

(48.3%)

AML Study Group (AMLSG)

AML HD93

AML HD98-A

- Increased in M4/M5

- extramedullary LAD

- Female predominance

- Decreased CD34 antigen expression

- Increased LDH

- Associated with FLT3 ITD

- WBC >20 K

- Increased bone marrow blast counts

Odds ratio (OR) after induction

CR 2.81

Schnittger, et al [15]

212/401

(52.9%)

German AMLCG99 study

- Associated with FLT3 ITD

- Without FLT3, OS and EFS increased

- Female predominance

Relative risk (RR)

EFS 0.527

Theide, et al [16]

408/1485

(27.5%)

Deutsche Studieninitiative Leukämie (DSIL) AML 96 protocol

- High bone marrow blasts

- Female predominance

- WBC >20 K

- Association with FLT3-ITD mutations

OR

OS 0.76

DFS 0.66

Boissel, et al [17]

50/106

(47%)

French Leukemia French Association (ALFA)

ALFA90

ALFA9802

- Increased in FAB M4/M5

- 25% with FLT3-ITD

- Decreased CEBPA

- WBC >20 K

No difference in CR or long term outcomes

Suzuki, et al [18]

64/257

(24.9%)

Japan Adult Leukemia Study Group protocols

- Associated with FLT3-ITD

- NPM1 mutant unfavorable factor for relapse

OR 2.106

- NPM1 wild type unfavorable for CR

OR 4.908

-NPM1 mutant with FLT3-ITD favorable for CR

OR 20.8