ASH 2021 | The impact of secondary-type mutations in NPM1-mutated AML

Jeffrey Lancet, MD, Moffitt Cancer Center, Tampa, FL, discusses the results of a study exploring the impact of mutations highly specific for secondary acute myeloid leukemia (AML) on NPM1-mutated AML. In the cohort of 159 patients, 101 had favorable risk, 44 had intermediate risk and 13 had adverse risk disease by ELN 2017 criteria. Results showed that patients with secondary-type mutations had significantly worse prognosis than patients without, despite being classified as favorable risk by ELN 2017 criteria at diagnosis. At a median follow-up of 35.5 months, overall survival (OS) was 14.7 months for patients with secondary mutations vs 57.6 months for patients without secondary mutations. In addition, allogeneic stem cell transplantation (alloSCT) was found to significantly impact OS. These findings suggest that the need for and timing of alloSCT should be further considered in patients with NPM1-mutated AML with secondary mutations. Results should be further assessed in a prospective study. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.