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

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Suárez EU
  • Boluda B
  • Lavilla E
  • Tormo M
  • Botella C
  • Gil C
  • Vives S
  • Rodríguez C
  • Serrano J
  • Sayas MJ
  • Martínez-Sánchez P
  • Ramos F
  • Bernal T
  • Algarra L
  • Bergua-Burgues JM
  • Pérez-Simón JA
  • Herrera P
  • Barrios M
  • Noriega-Concepción V
  • Raposo-Puglia JA
  • Ayala R
  • Barragán E
  • Martínez-Cuadrón D
  • Amigo ML
  • López-Lorenzo JL
  • Lázaro-García A
  • Guimaraes JE
  • García-Boyero R
  • De Rueda-Ciller B
  • Foncillas-García M
  • Hong A
  • Labrador J
  • Alonso-Dominguez JM
  • Montesinos P
  • PETHEMA group

Unidades

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.

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Datos de la publicación

ISSN/ISSNe:
0939-5555, 1432-0584

ANNALS OF HEMATOLOGY  SPRINGER

Tipo:
Article
Páginas:
2845-2851
PubMed:
38884787

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Keywords

  • Acute myeloid leukemia; Elderly; Fms-like tyrosine kinase 3 (FLT3) mutation; Hypomethylating; Nucleophosmin 1 (NPM1) mutation; PETHEMA; Treatment

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