1. Do NPM1 and FLT3-ITD mutations modify prognosis in patients treated with non-intensive regimens?
- Author
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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, Colorado M, García-Boyero R, De Rueda-Ciller B, Foncillas-García M, Hong A, Labrador J, Alonso-Dominguez JM, and Montesinos P
- Subjects
- Aged, Female, Humans, Male, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Prognosis, Retrospective Studies, Survival Rate, Vidarabine analogs & derivatives, Vidarabine therapeutic use, Vidarabine administration & dosage, fms-Like Tyrosine Kinase 3 genetics, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute drug therapy, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute diagnosis, Mutation, Nuclear Proteins genetics, Nucleophosmin
- 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.)
- Published
- 2024
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