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Blood, 1 December 2005, Vol. 106, No. 12, pp. 3740-3746.
Prepublished online as a Blood First Edition Paper on July 28, 2005; DOI 10.1182/blood-2005-05-2164.
Previous Article | Table of Contents | Next Article 
CLINICAL TRIALS AND OBSERVATIONS
Mutant nucleophosmin (NPM1) predicts favorable prognosis in younger adults with acute myeloid leukemia and normal cytogenetics: interaction with other gene mutations
Konstanze Döhner,
Richard F. Schlenk,
Marianne Habdank,
Claudia Scholl,
Frank G. Rücker,
Andrea Corbacioglu,
Lars Bullinger,
Stefan Fröhling,
Hartmut Döhner, for the AML Study Group (AMLSG)
From the Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany; and the Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
To assess the prognostic relevance of mutations in the NPM1 gene encoding a nucleocytoplasmic shuttle protein in younger adults with acute myeloid leukemia (AML) and normal cytogenetics, sequencing of NPM1 exon 12 was performed in diagnostic samples from 300 patients entered into 2 consecutive multicenter trials of the AML Study Group (AMLSG). Treatment included intensive double-induction therapy and consolidation therapy with high cumulative doses of high-dose cytarabine. NPM1 mutations were identified in 48% of the patients including 12 novel sequence variants, all leading to a frameshift in the C-terminus of the nucleophosmin 1 (NPM1) protein. Mutant NPM1 was associated with specific clinical, phenotypical, and genetic features. Statistical analysis revealed a significant interaction of NPM1 and FLT3 internal tandem duplications (ITDs). NPM1 mutations predicted for better response to induction therapy and for favorable overall survival (OS) only in the absence of FLT3 ITD. Multivariable analysis for OS revealed combined NPM1-mutated/FLT3 ITDnegative status, CEBPA mutation status, availability of a human leukocyte antigen (HLA)compatible donor, secondary AML, and lactate dehydrogenase (LDH) as prognostic factors. In conclusion, NPM1 mutations in the absence of FLT3 ITD define a distinct molecular and prognostic subclass of young-adult AML patients with normal cytogenetics.

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S. Frohling, R. F. Schlenk, S. Kayser, M. Morhardt, A. Benner, K. Dohner, H. Dohner, and for the German-Austrian AML Study Group
Cytogenetics and age are major determinants of outcome in intensively treated acute myeloid leukemia patients older than 60 years: results from AMLSG trial AML HD98-B
Blood,
November 15, 2006;
108(10):
3280 - 3288.
[Abstract]
[Full Text]
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B. Falini, M. P. Martelli, N. Bolli, R. Bonasso, E. Ghia, M. T. Pallotta, D. Diverio, I. Nicoletti, R. Pacini, A. Tabarrini, et al.
Immunohistochemistry predicts nucleophosmin (NPM) mutations in acute myeloid leukemia
Blood,
September 15, 2006;
108(6):
1999 - 2005.
[Abstract]
[Full Text]
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W. Chen, G. Z. Rassidakis, J. Li, M. Routbort, D. Jones, H. Kantarjian, L. J. Medeiros, and C. E. Bueso-Ramos
High frequency of NPM1 gene mutations in acute myeloid leukemia with prominent nuclear invaginations ("cuplike" nuclei).
Blood,
September 1, 2006;
108(5):
1783 - 1784.
[Full Text]
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M. D. Radmacher, G. Marcucci, A. S. Ruppert, K. Mrozek, S. P. Whitman, J. W. Vardiman, P. Paschka, T. Vukosavljevic, C. D. Baldus, J. E. Kolitz, et al.
Independent confirmation of a prognostic gene-expression signature in adult acute myeloid leukemia with a normal karyotype: a Cancer and Leukemia Group B study
Blood,
September 1, 2006;
108(5):
1677 - 1683.
[Abstract]
[Full Text]
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C. S. Wilson, G. S. Davidson, S. B. Martin, E. Andries, J. Potter, R. Harvey, K. Ar, Y. Xu, K. J. Kopecky, D. P. Ankerst, et al.
Gene expression profiling of adult acute myeloid leukemia identifies novel biologic clusters for risk classification and outcome prediction
Blood,
July 15, 2006;
108(2):
685 - 696.
[Abstract]
[Full Text]
[PDF]
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S. S. Farag, K. J. Archer, K. Mrozek, A. S. Ruppert, A. J. Carroll, J. W. Vardiman, M. J. Pettenati, M. R. Baer, M. B. Qumsiyeh, P. R. Koduru, et al.
Pretreatment cytogenetics add to other prognostic factors predicting complete remission and long-term outcome in patients 60 years of age or older with acute myeloid leukemia: results from Cancer and Leukemia Group B 8461
Blood,
July 1, 2006;
108(1):
63 - 73.
[Abstract]
[Full Text]
[PDF]
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B. Falini, N. Bolli, J. Shan, M. P. Martelli, A. Liso, A. Pucciarini, B. Bigerna, L. Pasqualucci, R. Mannucci, R. Rosati, et al.
Both carboxy-terminus NES motif and mutated tryptophan(s) are crucial for aberrant nuclear export of nucleophosmin leukemic mutants in NPMc+ AML
Blood,
June 1, 2006;
107(11):
4514 - 4523.
[Abstract]
[Full Text]
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C. Thiede, S. Koch, E. Creutzig, C. Steudel, T. Illmer, M. Schaich, G. Ehninger, and for the Deutsche Studieninitiative Leukamie (DSIL)
Prevalence and prognostic impact of NPM1 mutations in 1485 adult patients with acute myeloid leukemia (AML)
Blood,
May 15, 2006;
107(10):
4011 - 4020.
[Abstract]
[Full Text]
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G. Roti, R. Rosati, R. Bonasso, P. Gorello, D. Diverio, M. F. Martelli, B. Falini, C. Mecucci, and for the Gruppo Italiano Malattie Ematologiche dell
Denaturing High-Performance Liquid Chromatography: A Valid Approach for Identifying NPM1 Mutations in Acute Myeloid Leukemia
J. Mol. Diagn.,
May 1, 2006;
8(2):
254 - 259.
[Abstract]
[Full Text]
[PDF]
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W.-C. Chou, J.-L. Tang, L.-I. Lin, M. Yao, W. Tsay, C.-Y. Chen, S.-J. Wu, C.-F. Huang, R.-J. Chiou, M.-H. Tseng, et al.
Nucleophosmin Mutations in De novo Acute Myeloid Leukemia: The Age-Dependent Incidences and the Stability during Disease Evolution.
Cancer Res.,
March 15, 2006;
66(6):
3310 - 3316.
[Abstract]
[Full Text]
[PDF]
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K. Mrozek and C. D. Bloomfield
Chromosome Aberrations, Gene Mutations and Expression Changes, and Prognosis in Adult Acute Myeloid Leukemia
Hematology,
January 1, 2006;
2006(1):
169 - 177.
[Abstract]
[Full Text]
[PDF]
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