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ASH 2025 | Mutation profiling in patients with secondary compared with de novo AML: a ALWP/EBMT study
Arnon Nagler, MD, Chaim Sheba Medical Center, Tel Aviv, Israel,
discusses a study from the ALWP/EBMT on next-generation sequencing-based mutation profiling in patients with secondary compared with de novo acute myeloid leukemia (AML) undergoing allogeneic stem cell transplantation (alloSCT). Prof. Nagler highlights that the mutation panel differs between secondary and primary AML. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
Today we know that the prognosis of AML, and also with conventional therapy but also with transplantation, is that the most important factor is the mutation makeup of the AML. And the secondary AML, which was used to be defined as AML after antecedent hematological malignancy or disorder, is now defined by mutation profile. So with the next-generation sequencing in the acute leukemia working party data, we wanted to compare the mutation profile of patients with primary AML, de novo AML, to those with secondary AML, and then to see the results...
Today we know that the prognosis of AML, and also with conventional therapy but also with transplantation, is that the most important factor is the mutation makeup of the AML. And the secondary AML, which was used to be defined as AML after antecedent hematological malignancy or disorder, is now defined by mutation profile. So with the next-generation sequencing in the acute leukemia working party data, we wanted to compare the mutation profile of patients with primary AML, de novo AML, to those with secondary AML, and then to see the results. And indeed, the mutation panel was different in secondary AML and primary AML. So in secondary AML, there were splicing mutations, there were more KRAS mutations, more TP53, while in the de novo AML it was, and more JAK2 was in secondary AML, while in the de novo AML it was mostly NPM1 and FLT3. And then we correlated the mutation profile with transplantation outcome, and for instance, this is not a new finding, TP53 was dictating a poor prognosis. And for the other mutation panel, this is a work that is still in progress.
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