Acute myeloid leukemia with NPM1 mutation and favorable European LeukemiaNet category: outcome after preemptive intervention based on measurable residual disease.
acute myeloid leukaemia
leukaemia
molecular analysis
stem cell transplantation
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
10
03
2020
accepted:
18
05
2020
pubmed:
9
6
2020
medline:
17
3
2021
entrez:
9
6
2020
Statut:
ppublish
Résumé
In the European LeukemiaNet favourable risk category, allogeneic haematopoietic stem cell transplantation (alloSCT) is not indicated in first complete remission for patients with acute myeloid leukaemia (AML) with NPM1 mutations (ELNfav NPM1 AML), although a proportion of these patients will relapse. Given the prognostic importance of measurable residual disease (MRD), CETLAM-12 considered a pre-emptive intervention in patients with molecular failure (MF). We analyzed 110 ELNfav NPM1 AML patients achieving complete remission (CR) after induction chemotherapy. Two-year cumulative incidence of relapse (CIR), overall survival (OS) and leukaemia-free survival (LFS) were 17%, 81·5% and 82%, respectively. Forty-six patients required additional therapy for MF (n = 33) or haematological relapse (HemR; n = 13), resulting in a molecular LFS (molLFS) and a cumulative incidence of MF at two years of 61% and 38% respectively. Two-year OS for these 46 patients was 66%, with a different outcome between patients with MF (86%) and HemR (42%) (P = 0·002). Quantitative NPM1 detection at different timepoints was predictive of molLFS; an MRD ratio (NPM1mut/ABL1 × 100) cut-off of 0·05 after first consolidation identified two cohorts with a two-year molLFS of 77% and 40% for patients below and above 0·05, respectively. In conclusion, MRD-based pre-emptive intervention resulted in a favourable outcome for ELNfav NPM1 AML patients.
Substances chimiques
NPM1 protein, human
0
Neoplasm Proteins
0
Nuclear Proteins
0
Nucleophosmin
117896-08-9
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
52-61Subventions
Organisme : Fondo de Investigaciones Sanitarias/Instituto de Salud Carlos III (ISCIII)
ID : PI 16/01027
Organisme : Generalitat de Catalunya
ID : SLT002/16/00433
Organisme : Generalitat de Catalunya
ID : SGR 1655
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 British Society for Haematology and John Wiley & Sons Ltd.
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