{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:41:21Z","timestamp":1772779281356,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p><jats:italic>NPM1<\/jats:italic> mutated AML without <jats:italic>FLT3\u2010ITD<\/jats:italic> is considered \u201cfavorable\u201d per the recent ELN 2022 criteria. However, our center has been challenged with treatment\u2010refractory patients, prompting a search for additional prognostic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed records of <jats:italic>NPM1<\/jats:italic> AML patients from 2015 to 2024. Factors associated with event\u2010free survival (EFS) and overall survival (OS) were evaluated using Cox regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 141 patients with <jats:italic>NPM1<\/jats:italic> AML, subtype A was the most common (<jats:italic>N<\/jats:italic>\u2009=\u200999), followed by subtype D (<jats:italic>N<\/jats:italic>\u2009=\u200910), subtype B (<jats:italic>N<\/jats:italic>\u2009=\u20096), subtype G\/I\/J\/K\/R (<jats:italic>N<\/jats:italic>\u2009=\u20093\/5\/3\/2\/1) and other subtypes (<jats:italic>N<\/jats:italic>\u2009=\u200912). Ninety patients received chemotherapy (chemo), 41 received hypomethylating agent +\/\u2212 venetoclax (HMA\/ven) and 10 did not receive specific anti\u2010AML therapy. At 12\u2009months, EFS for subtypes A, D, B, G\/I\/J\/K\/R, and other subtypes were 49%, 58%, 50%, 49%, and 31%, and OS were 71%, 79%, 50%, 44%, and 56%, respectively. Fifty patients had allogeneic stem cell transplants: 33 in CR1 and 17 in CR2+. EFS at 12\u2009months post\u2010HSCT was 72%.<\/jats:p><jats:p>On multivariable analysis, co\u2010mutation with <jats:italic>KRAS<\/jats:italic> (HR: 2.69, 95% CI: 1.20\u20136.00) or <jats:italic>TET2<\/jats:italic> (HR: 1.99, 95% CI: 1.22\u20133.26) was associated with worse EFS. For each 50\u2009k\/mm<jats:sup>3<\/jats:sup> increase in WBC at diagnosis, the risk of relapse or death increased by 21%. For OS, co\u2010mutation with <jats:italic>IDH1\/IDH2<\/jats:italic> (HR: 0.40, 95% CI: 0.21\u20130.74) was associated with better OS, whereas co\u2010mutation with <jats:italic>SRSF2<\/jats:italic> (HR: 2.70, 95% CI: 1.35\u20135.40) was associated with worse OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We did not find a statistically significant difference in EFS and OS among the <jats:italic>NPM1<\/jats:italic> subtypes. However, our results showed that the prognoses of <jats:italic>NPM1<\/jats:italic> AML can be influenced by other co\u2010occurring mutations. A larger study is needed to confirm our findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14415","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T04:20:02Z","timestamp":1742358002000},"page":"29-35","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of <scp><i>NPM1<\/i><\/scp> Mutation Subtype and Co\u2010Mutation Patterns on the Outcomes of Acute Myeloid Leukemia"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5038-7093","authenticated-orcid":false,"given":"Kittika","family":"Poonsombudlert","sequence":"first","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratdanai","family":"Yodsuwan","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Mott","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Crawford","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hornberg","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony N.","family":"Snow","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grerk","family":"Sutamtewagul","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarida","family":"Magalhaes\u2010Silverman","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prajwal","family":"Dhakal","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Holden Comprehensive Cancer Center  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010022\u201001613\u20101"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019002697"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001335"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016867"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15041177"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019004226"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.190959"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404597"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1209453"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.133819"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102023\u2010181872"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13143457"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.HS9.0000843412.59637.1b"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010021\u201001368\u20101"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010023\u201002016\u20106"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.269134"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26694"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V114.22.163.163"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26731"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.2886"},{"key":"e_1_2_9_23_1","article-title":"TP53\/NPM1\u2010Mutated Acute Myeloid Leukemia as a Molecularly Distinct Disease Entity","author":"Scarpa F. J.","year":"2021","journal-title":"Wolters Kluwer Health"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012732"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40164\u2010023\u201000449\u20104"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507471"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023096"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.HS9.0000968924.19161.da"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010023\u201005812\u20103"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022007563"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.14415","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T09:30:22Z","timestamp":1754904622000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.14415"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/ejh.14415"],"URL":"https:\/\/doi.org\/10.1111\/ejh.14415","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,19]]},"assertion":[{"value":"2024-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}