학술논문
Do NPM1 and FLT3-ITD mutations modify prognosis in patients treated with non-intensive regimens?
Document Type
Original Paper
Author
Suárez, E. U.; Boluda, B.; Lavilla, E.; Tormo, M.; Botella, C.; Gil, C.; Vives, S.; Rodríguez, C.; Serrano, J.; Sayas, M. J.; Martínez-Sánchez, P.; Ramos, F.; Bernal, T.; Algarra, L.; Bergua-Burgues, J. M.; Pérez-Simón, J. A.; Herrera, P.; Barrios, M.; Noriega-Concepción, V.; Raposo-Puglia, J. A.; Ayala, R.; Barragán, E.; Martínez-Cuadrón, D.; Amigo, M. L.; López-Lorenzo, J. L.; Lázaro-García, A.; Guimaraes, J. E.; Colorado, M.; García-Boyero, R.; De Rueda-Ciller, B.; Foncillas-García, M.; Hong, A.; Labrador, J.; Alonso-Dominguez, J. M.; Montesinos, P.
Source
Annals of Hematology. :1-7
Subject
Language
English
ISSN
0939-5555
1432-0584
1432-0584
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.