TY - JOUR
T1 - Clinical characteristics and prognostic implications of NPM1 mutations in acute myeloid leukemia
AU - Suzuki, Tatsuya
AU - Kiyoi, Hitoshi
AU - Ozeki, Kazutaka
AU - Tomita, Akihiro
AU - Yamaji, Satomi
AU - Suzuki, Ritsuro
AU - Kodera, Yoshihisa
AU - Miyawaki, Shuichi
AU - Asou, Norio
AU - Kuriyama, Kazutaka
AU - Yagasaki, Fumiharu
AU - Shimazaki, Chihiro
AU - Akiyama, Hideki
AU - Nishimura, Miki
AU - Motoji, Toshiko
AU - Shinagawa, Katsuji
AU - Takeshita, Akihiro
AU - Ueda, Ryuzo
AU - Kinoshita, Tomohiro
AU - Emi, Nobuhiko
AU - Naoe, Tomoki
PY - 2005/10
Y1 - 2005/10
N2 - Recently, somatic mutations of the nucleophosmin gene (NPM1), which alter the subcellular localization of the product, have been reported in acute myeloid leukemia (AML). We analyzed the clinical significance of NPM1 mutations in comparison with cytogenetics, FLT3, NRAS, and TP53 mutations, and a partial tandem duplication of the MLL gene (MLL-TD) in 257 patients with AML. We found NPM1 mutations, including 4 novel sequence variants, in 64 of 257 (24.9%) patients. NPM1 mutations were associated with normal karyotype and with internal tandem duplication (ITD) and D835 mutations in FLT3, but not with other mutations. In 190 patients without the M3 French-American-British (FAB) subtype who were treated with the protocol of the Japan Adult Leukemia Study Group, multivariate analyses showed that the NPM1 mutation was a favorable factor for achieving complete remission but was associated with a high relapse rate. Sequential analysis using 39 paired samples obtained at diagnosis and relapse showed that NPM1 mutations were lost at relapse in 2 of the 17 patients who had NPM1 mutations at diagnosis. These results suggest that the NPM1 mutation is not necessarily an early event during leukemogenesis or that leukemia clones with NPM1 mutations are sensitive to chemotherapy.
AB - Recently, somatic mutations of the nucleophosmin gene (NPM1), which alter the subcellular localization of the product, have been reported in acute myeloid leukemia (AML). We analyzed the clinical significance of NPM1 mutations in comparison with cytogenetics, FLT3, NRAS, and TP53 mutations, and a partial tandem duplication of the MLL gene (MLL-TD) in 257 patients with AML. We found NPM1 mutations, including 4 novel sequence variants, in 64 of 257 (24.9%) patients. NPM1 mutations were associated with normal karyotype and with internal tandem duplication (ITD) and D835 mutations in FLT3, but not with other mutations. In 190 patients without the M3 French-American-British (FAB) subtype who were treated with the protocol of the Japan Adult Leukemia Study Group, multivariate analyses showed that the NPM1 mutation was a favorable factor for achieving complete remission but was associated with a high relapse rate. Sequential analysis using 39 paired samples obtained at diagnosis and relapse showed that NPM1 mutations were lost at relapse in 2 of the 17 patients who had NPM1 mutations at diagnosis. These results suggest that the NPM1 mutation is not necessarily an early event during leukemogenesis or that leukemia clones with NPM1 mutations are sensitive to chemotherapy.
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U2 - 10.1182/blood-2005-04-1733
DO - 10.1182/blood-2005-04-1733
M3 - Article
C2 - 15994285
AN - SCOPUS:24144494881
SN - 0006-4971
VL - 106
SP - 2854
EP - 2861
JO - Blood
JF - Blood
IS - 8
ER -