Abstract
Frameshift mutations of the nucleophosmin gene (NPM1) were recently reported as a frequently occurring abnormality in patients with de novo acute myeloid leukemia (AML). To evaluate the frequency of NPM1 mutations in patients with therapy-related myelodysplasia (t-MDS) and therapy-related AML (t-AML), and their possible association to type of previous therapy and to other gene mutations, 140 patients with t-MDS or t-AML were analyzed for mutations of NPM1. NPM1 mutations were observed in 7 of 51 patients presenting as overt t-AML, as compared to only 3 of 89 patients presenting as t-MDS (P=0.037). The mutations were not related to any specific type of previous therapy, but they were significantly associated with a normal karyotype and mutations of FLT3 (P=0.0002 for both comparisons). Only 1 of 10 patients with NPM1 mutations presented chromosome aberrations characteristic of therapy-related disease, and 7q−/−7, the most frequent abnormalities of t-MDS/t-AML, were not observed (P=0.002). This raises the question whether some of the cases presenting NPM1 mutations were in fact cases of de novo leukemia. The close association to class I mutations and the inverse association to class II mutations suggest mutations of NPM1 as representing a class II mutation-like abnormality in AML.
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Acknowledgements
We thank Pia Maj-Britt Bech for her technical assistance and Severin Olesen Larsen for his help with the statistical calculations. This work was supported by grants from The Danish Cancer Society.
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Andersen, M., Andersen, M., Christiansen, D. et al. NPM1 mutations in therapy-related acute myeloid leukemia with uncharacteristic features. Leukemia 22, 951–955 (2008). https://doi.org/10.1038/leu.2008.17
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DOI: https://doi.org/10.1038/leu.2008.17
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