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Blood, 1 December 2005, Vol. 106, No. 12, pp. 3733-3739. Prepublished online as a Blood First Edition Paper on August 2, 2005; DOI 10.1182/blood-2005-06-2248. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-06-2248v1 106/12/3733    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Schnittger, S. Articles by Falini, B. Search for Related Content PubMed PubMed Citation Articles by Schnittger, S. Articles by Falini, B. Related Collections Oncogenes and Tumor Suppressors Clinical Trials and Observations Neoplasia Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Nucleophosmin gene mutations are predictors of favorable prognosis in acute myelogenous leukemia with a normal karyotype Susanne Schnittger, Claudia Schoch, Wolfgang Kern, Cristina Mecucci, Claudia Tschulik, Massimo F. Martelli, Torsten Haferlach, Wolfgang Hiddemann, and Brunangelo Falini From the Department of Internal Medicine III, University Hospital Grosshadern, Ludwig Maximilian's University, Munich, Germany; the Clinical Cooperative Group Acute Leukemia, Gesellschaft für Strahlenforschung (GSF) Research Center for Environment and Health, Munich, Germany; and the Institute of Hematology, Policlinico, Monteluce, Perugia, Italy. Nucleophosmin (NPM1) exon-12 gene mutations are the hallmark of a large acute myelogenous leukemia (AML) subgroup with normal karyotype, but their prognostic value in this AML subset has not yet been determined. We screened 401 AML patients with normal karyotype treated within the German AML Cooperative Group Protocol 99 (AMLCG99) study for NPM1 mutations. Results were related with partial tandem duplications within the MLL gene (MLL-PTD), Fms-like tyrosine kinase 3–length mutations (FLT3-LM), the tyrosine kinase domain of FLT3 (FLT3-TKD), NRAS, KIT, and CEBPA mutations and with clinical characteristics and outcome. NPM1 mutations were detected in 212 (52.9%) of 401 patients. Fourteen mutations, including 8 new variants, were identified. NPM1-mutated cases associated frequently with FLT3 mutations but rarely with other mutations. The NPM1-mutated group had a higher complete remission (CR) rate (70.5% vs 54.7%, P = .003), a trend to a longer overall survival (OS; median 1012 vs 549 days, P = .076), and significantly longer event-free survival (EFS; median 428 vs 336 days; P = .012). The favorable impact of NPM1 mutations on OS and EFS clearly emerged in the large group (264 [66.8%] of 395 cases) of normal-karyotype AML without FLT3-LM. This positive effect was lost in the presence of a concomitant FLT3-LM, since survival of the NPM1+/FLT3-LM+ double positive was similar to NPM1–/FLT3-LM+ cases. In conclusion, this study demonstrates that NPM1+/FLT3-LM– mutations are an independent predictor for a favorable outcome in AML with normal karyotype. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Dueling mutations in normal karyotype AML Robert E. Gallagher Blood 2005 106: 3681-3682. 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