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The prognostic impact of FLT3-ITD and NPM1 mutation in adult AML is age-dependent in the population-based setting

Juliusson, Gunnar LU ; Jädersten, Martin ; Deneberg, Stefan ; Lehmann, Sören ; Möllgård, Lars ; Wennström, Lovisa ; Antunovic, Petar ; Cammenga, Jörg LU ; Lorenz, Fryderyk and Ölander, Emma , et al. (2020) In Blood Advances 4(6). p.1094-1101
Abstract

In acute myeloid leukemia (AML) FLT3 internal tandem duplication (ITD) and nucleophosmin 1 (NPM1) mutations provide prognostic information with clinical relevance through choice of treatment, but the effect of age and sex on these molecular markers has not been evaluated. The Swedish AML Registry contains data on FLT3-ITD and NPM1 mutations dating to 2007, and 1570 adult patients younger than 75 years, excluding acute promyelocytic leukemia, had molecular results reported. Females more often had FLT3ITD and/or NPM1mut (FLT3ITD: female, 29%; male, 22% [P = .0015]; NPM1mut: female, 36%; male, 27% [P = .0001]), and more males were double negative (female, 53%; male, 64%; P < .0001). Patients with FLT3ITD were younger than those without... (More)

In acute myeloid leukemia (AML) FLT3 internal tandem duplication (ITD) and nucleophosmin 1 (NPM1) mutations provide prognostic information with clinical relevance through choice of treatment, but the effect of age and sex on these molecular markers has not been evaluated. The Swedish AML Registry contains data on FLT3-ITD and NPM1 mutations dating to 2007, and 1570 adult patients younger than 75 years, excluding acute promyelocytic leukemia, had molecular results reported. Females more often had FLT3ITD and/or NPM1mut (FLT3ITD: female, 29%; male, 22% [P = .0015]; NPM1mut: female, 36%; male, 27% [P = .0001]), and more males were double negative (female, 53%; male, 64%; P < .0001). Patients with FLT3ITD were younger than those without (59 vs 62 years; P = .023), in contrast to patients with NPM1mut (62 vs 60 years; P = .059). Interestingly, their prognostic effect had a strong dependence on age: FLT3ITD indicated poor survival in younger patients (<60 years; P = .00003), but had no effect in older patients (60-74 years; P = .5), whereas NPM1mut indicated better survival in older patients (P = .00002), but not in younger patients (P = .95). In FLT3ITD/NPM1mut patients, the survival was less dependent on age than in the other molecular subsets. These findings are likely to have clinical relevance for risk grouping, study design, and choice of therapy.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood Advances
volume
4
issue
6
pages
8 pages
publisher
American Society of Hematology
external identifiers
  • pmid:32203582
  • scopus:85082326939
ISSN
2473-9529
DOI
10.1182/bloodadvances.2019001335
language
English
LU publication?
yes
additional info
© 2020 by The American Society of Hematology.
id
175a5f96-bb26-4c9f-89fa-8e3430df53ee
date added to LUP
2020-03-26 06:44:11
date last changed
2023-11-20 01:47:53
@article{175a5f96-bb26-4c9f-89fa-8e3430df53ee,
  abstract     = {{<p>In acute myeloid leukemia (AML) FLT3 internal tandem duplication (ITD) and nucleophosmin 1 (NPM1) mutations provide prognostic information with clinical relevance through choice of treatment, but the effect of age and sex on these molecular markers has not been evaluated. The Swedish AML Registry contains data on FLT3-ITD and NPM1 mutations dating to 2007, and 1570 adult patients younger than 75 years, excluding acute promyelocytic leukemia, had molecular results reported. Females more often had FLT3ITD and/or NPM1mut (FLT3ITD: female, 29%; male, 22% [P = .0015]; NPM1mut: female, 36%; male, 27% [P = .0001]), and more males were double negative (female, 53%; male, 64%; P &lt; .0001). Patients with FLT3ITD were younger than those without (59 vs 62 years; P = .023), in contrast to patients with NPM1mut (62 vs 60 years; P = .059). Interestingly, their prognostic effect had a strong dependence on age: FLT3ITD indicated poor survival in younger patients (&lt;60 years; P = .00003), but had no effect in older patients (60-74 years; P = .5), whereas NPM1mut indicated better survival in older patients (P = .00002), but not in younger patients (P = .95). In FLT3ITD/NPM1mut patients, the survival was less dependent on age than in the other molecular subsets. These findings are likely to have clinical relevance for risk grouping, study design, and choice of therapy.</p>}},
  author       = {{Juliusson, Gunnar and Jädersten, Martin and Deneberg, Stefan and Lehmann, Sören and Möllgård, Lars and Wennström, Lovisa and Antunovic, Petar and Cammenga, Jörg and Lorenz, Fryderyk and Ölander, Emma and Lazarevic, Vladimir and Höglund, Martin}},
  issn         = {{2473-9529}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{6}},
  pages        = {{1094--1101}},
  publisher    = {{American Society of Hematology}},
  series       = {{Blood Advances}},
  title        = {{The prognostic impact of FLT3-ITD and NPM1 mutation in adult AML is age-dependent in the population-based setting}},
  url          = {{http://dx.doi.org/10.1182/bloodadvances.2019001335}},
  doi          = {{10.1182/bloodadvances.2019001335}},
  volume       = {{4}},
  year         = {{2020}},
}