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

Autor: Suárez EU; Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain., Boluda B; Hospital Universitari I Politécnic-IIS La Fe, Valencia, Spain., Lavilla E; Hospital Universitario Lucus Augusti, Lugo, Spain., Tormo M; Hospital Clínico Universitario de Valencia, Valencia, Spain.; INCLIVA, Valencia, Spain., Botella C; Hospital General Universitario de Alicante, Alicante, Spain., Gil C; Hospital General Universitario de Alicante, Alicante, Spain., Vives S; ICO-Hospital Germans Trias I Pujol, Badalona, Spain., Rodríguez C; Hospital Universitario Dr Negrín, Las Palmas, Spain., Serrano J; Hospital Universitario Reina Sofía, Córdoba, Spain.; IMIBIC, Córdoba, Spain., Sayas MJ; Hospital Universitario Dr. Peset, Valencia, Spain., Martínez-Sánchez P; Hospital Universitario 12 de Octubre, Madrid, Spain., Ramos F; Hospital Universitario de León, León, Spain., Bernal T; Hospital Universitario Central de Asturias, Oviedo, Spain., Algarra L; Hospital Universitario General de Albacete, Albacete, Spain., Bergua-Burgues JM; Hospital San Pedro de Alcántara, Cáceres, Spain., Pérez-Simón JA; Hospital Universitario Virgen del Rocío, Seville, Spain.; Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Seville, Spain., Herrera P; Hospital Universitario Puerta de Hierro, Majadahonda, Spain., Barrios M; Hospital Regional Universitario de Málaga, Málaga, Spain., Noriega-Concepción V; Hospital Universitario de A Coruña, A Coruña, Spain., Raposo-Puglia JA; Hospital Universitario Puerta del Mar de Cádiz, Cádiz, Spain., Ayala R; Haematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, CNIO, CIBERONC, Madrid, Spain.; Spanish National Cancer Research Center (CNIO), Madrid, Spain., Barragán E; Hospital Universitari I Politécnic-IIS La Fe, Valencia, Spain., Martínez-Cuadrón D; Hospital Universitari I Politécnic-IIS La Fe, Valencia, Spain., Amigo ML; Hospital General Universitario Morales Meseguer, Murcia, Spain., López-Lorenzo JL; Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain., Lázaro-García A; Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain., Guimaraes JE; Centro Hospitalar São João, Oporto, Portugal., Colorado M; Hospital Universitario Marqués de Valdecilla, Santander, Spain., García-Boyero R; Hospital General Universitario de Castellón, Castellón de La Plana, Spain., De Rueda-Ciller B; Hospital Universitario Miguel Servet, Saragossa, Spain., Foncillas-García M; Hospital Universitario Infanta Leonor, Madrid, Spain., Hong A; Hospital Universitario Doctor José Molina Orosa, Arrecife, Spain., Labrador J; Hospital Universitario de Burgos, Burgos, Spain., Alonso-Dominguez JM; Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain. juan.adominguez@fjd.es., Montesinos P; Hospital Universitari I Politécnic-IIS La Fe, Valencia, Spain.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2024 Aug; Vol. 103 (8), pp. 2845-2851. Date of Electronic Publication: 2024 Jun 17.
DOI: 10.1007/s00277-024-05840-7
Abstrakt: 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.)
Databáze: MEDLINE
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