Clinical characteristics and prognostic implications of NPM1 mutations in acute myeloid leukemia.
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.
Suzuki
Tatsuya
T
Department of Infectious Diseases, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan.
Kiyoi
Hitoshi
H
Ozeki
Kazutaka
K
Tomita
Akihiro
A
Yamaji
Satomi
S
Suzuki
Ritsuro
R
Kodera
Yoshihisa
Y
Miyawaki
Shuichi
S
Asou
Norio
N
Kuriyama
Kazutaka
K
Yagasaki
Fumiharu
F
Shimazaki
Chihiro
C
Akiyama
Hideki
H
Nishimura
Miki
M
Motoji
Toshiko
T
Shinagawa
Katsuji
K
Takeshita
Akihiro
A
Ueda
Ryuzo
R
Kinoshita
Tomohiro
T
Emi
Nobuhiko
N
Naoe
Tomoki
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D018450:Disease Progression; D005091:Exons / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000145:classification / Q000175:diagnosis* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation / Q000235:genetics*; D009687:Nuclear Proteins / Q000235:genetics*; D000090243:Nucleophosmin; D011379:Prognosis; D015996:Survival Rate
C000716967:NPM1 protein, human; D009687:Nuclear Proteins; D000090243:Nucleophosmin