Clinical implications of non-A-type NPM1 and FLT3 mutations in patients with normal karyotype acute myeloid leukemia

Abstract

Mutations in the nucleophosmin (NPM1) and fms-like tyrosine kinase-3 (FLT3) genes are the most commonly observed mutations in patients with normal-karyotype acute myeloid leukemia (AML-NK). We analyzed the prognostic effects and interactions of these mutations in 201 AML-NK patients. NPM1 and FLT3 mutations were found in 38.3 and 24.9% of AML-NK patients, respectively. NPM1 mutations (NPM1 mut), especially in patients without FLT3 mutations (FLT3 mut), were associated with a favorable outcome. However, NPM1 mut did not affect survival. FLT3 mut tended to be associated with a poor survival outcome. FLT3 mut showed no prognostic effects in patients with A-type NPM1 mut. However, FLT3 mut were associated with a significantly worse prognosis in patients with non-A-type NPM1 mut. The prognostic interaction between the NPM1 and FLT3 mutations was significant in patients with non-A-type NPM1 mut. Copyright © 2011 S. Karger AG, Basel.