The Prognostic Impact of Additional Molecular and Cytogenetic Abnormalities on AML Patients with NPM1- and/or FLT3-ITD Mutations Receiving Intensive Chemotherapy: Real-World Data from the Greek Registry
<b>Background/Objective:</b> The prognostic impact of additional cytogenetic aberrations and molecular abnormalities (such as MDS-related mutations, mutations in myeloid genes and the <i>KRAS/NRAS</i> mutations) in patients with <i>NPM1</i>- and/or <i>FLT3</i>-ITD-mutated AML remains elusive. <b>Methods:</b> This retrospective, multicentre study of real-world data aimed to investigate the impact of these mutations and cytogenetic abnormalities on the prognosis of patients with <i>NPM1</i>- and/or <i>FLT3</i>-ITD-mutated AML, treated with intensive chemotherapy. <b>Results:</b> In a cohort of 161 patients, the only parameters identified to affect the outcomes (EFS and OS) were the age of the patient, primary refractory disease, the presence of a <i>NPM1</i> mutation and the use of allogenic stem cell transplantation (allo-SCT) within the first complete remission. More specifically, ages below the median conferred significantly improved outcomes, whereas primary refractory disease exhibited a negative correlation with the EFS and OS. Subsequent subgroup analysis, stratifying patients into three groups (Group 1: <i>NPM1</i><sup>mutated</sup>/<i>FLT3</i><sup>wt</sup>; Group 2: <i>NPM1</i><sup>mutated</sup>/<i>FLT3</i><sup>mutated</sup>; Group 3: <i>NPM1</i><sup>wt</sup>/<i>FLT3</i><sup>mutated</sup>). revealed that allo-SCT in CR1 improved the outcomes (EFS and OS) in Groups 2 and 3, but had no additional impact in Group 1. <b>Conclusions:</b> Age, primary refractory disease and allogenic stem cell transplantation in the first complete response were found to have a prognostic impact on outcomes, Interestingly, no significant association was detected between the poor prognostic cytogenetic abnormalities or the presence of additional mutations in myeloid genes, MDS-related genes or KRAS/NRAS genes and the outcomes in any group of patients.
Authors
- Ιωάννα Λαζανά (ORCID: https://orcid.org/0000-0002-5162-1304)
- Konstantinos Gkirkas
- Lydia Kyriazopoulou (ORCID: https://orcid.org/0000-0002-6534-4061)
- Τατιάνα Τζένου (ORCID: https://orcid.org/0000-0003-3281-5303)
- Apostolia Papalexandri
- Alexandros Spyridonidis (ORCID: https://orcid.org/0000-0003-3097-2532)
- Eleni Kapsali (ORCID: https://orcid.org/0000-0002-5304-7553)
- Maria Liga
- Evrydiki Michalis
- Ioannis Konstantellos (ORCID: https://orcid.org/0009-0008-8802-4109)
- Ioanna Sakellari (ORCID: https://orcid.org/0000-0003-4325-8856)
- Panagiotis Tsirigotis (ORCID: https://orcid.org/0000-0002-3522-3680)
- Irene Tziotziou
- Ioannis Baltadakis
- Chrysavgi Lalayanni (ORCID: https://orcid.org/0000-0003-1244-6416)
- Maria Garofalaki
- Anastasia Sioni
- Theodoros P. Vassilakopoulos (ORCID: https://orcid.org/0000-0001-8766-1853)
- Theoni Leonidopoulou
- Maria Papathanassiou
- Maria K. Angelopoulou (ORCID: https://orcid.org/0000-0002-1596-3630)
- Vasiliki Violaki
- Anastasia Kopsaftopoulou
- Eleni Plata
- Dimitrios Kiousiafes
Institutions
- National and Kapodistrian University of Athens (GR)
- Sismanoglio General Hospital (GR)
- Agios Pavlos General Hospital (GR)
- General University Hospital of Patras (GR)
- General Hospital of Athens G. Genimatas (GR)
- Laiko General Hospital of Athens (GR)
- St Savas Hospital (GR)
- Chania General Hospital ”St. George” (GR)
- University General Hospital Attikon (GR)
- University Hospital of Ioannina (GR)
- G. Papanikolaou General Hospital (GR)
Publication Details
- Journal
- Cancers
- Published
- 2025-02-16
- DOI
- https://doi.org/10.3390/cancers17040667
- Citations
- 1
- Primary Topic
- Acute Myeloid Leukemia Research
- Type
- article
- Field-Weighted Citation Impact
- 1.77
Funders
- Pfizer