{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:59:11Z","timestamp":1790035151561,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p><jats:italic>NPM1<\/jats:italic>\u2010mutated (<jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup>) myeloid neoplasms (MNs) with &lt;20% bone marrow (BM) blasts (<jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs&lt;20) are uncommon, and their classification remains inconsistent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinicopathologic features of 54 patients with <jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs &lt;20 were evaluated and compared with wild\u2010type <jats:italic>NPM1<\/jats:italic> MNs &lt;20 and <jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs\u226520, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs had similar features regardless of blast percentage, except for higher <jats:italic>IDH2<\/jats:italic> (29% vs 7%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.023) and <jats:italic>FLT3<\/jats:italic> (70% vs 11%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) frequency in patients with \u226520% BM blasts. Thirty\u2010three (61%) patients with <jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs &lt;20 received low\u2010intensity chemotherapy (LIC) and 12 (22%) received intensive chemotherapy (IC). Higher complete remission rates (75% vs 27%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.006) and median overall survival (mOS) (not reached vs 30.4 months, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.06) were observed with IC compared to LIC. Young patients (age &lt;60 years) did not reach mOS either when treated with LIC or IC. Stem cell transplant was associated with increased survival only in patients treated with LIC (HR, 0.24; <jats:italic>p\u00a0=\u00a0<\/jats:italic>.025). No differences in mOS were observed by BM blast strata (32.2 months, not reached and 46.9 months for &lt;10%, 10%\u201319%, and \u226520% blasts, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.700) regardless of treatment modality (LIC: <jats:italic>p\u00a0=\u00a0<\/jats:italic>.900; IC: <jats:italic>p\u00a0=\u00a0<\/jats:italic>.360). Twenty\u2010three patients (43%) with <jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs &lt;20 had marrow blast progression to \u226520%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, <jats:italic>NPM1<\/jats:italic><jats:sup>mut<\/jats:sup> MNs define a unique entity independent of BM blast percentage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35433","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T09:35:45Z","timestamp":1718789745000},"page":"3452-3462","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["<i>NPM1<\/i>\u2010mutated myeloid neoplasms are a unique entity not defined by bone marrow blast percentage"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8857-2748","authenticated-orcid":false,"given":"Georgina","family":"Gener\u2010Ricos","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6085-2745","authenticated-orcid":false,"given":"Alex","family":"Bataller","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jose","family":"Rodriguez\u2010Sevilla","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas 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