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 |