Clinical impact of tyrosine kinases related mutations in NPM1 mutated acute myeloid leukaemia: A report from the Northern Italy Leukaemia Group (NILG) multicentre randomized trial 02/06.

Co-mutational patterns play a role in the clinical outcome of nucleophosmin-1 (NPM1) mutated acute myeloid leukaemia (AML). Tyrosine kinase (TK) related gene mutations are included in these additional mutations, but their impact on prognosis of NPM1-mutated AML is unknown. We analyzed the outcomes of patients with NPM1 AML with TK related mutations treated with intensive chemotherapy in the prospective randomized trial NILG AML 02/06, with regards to NPM1-FLT3-ITD and NPM1-isolated. Data show that additional TK related mutations do not impact the favorable prognosis on NPM1-mutated AML, unlike NPM1-FLT3-ITD mutated AML, for which consolidation with allogeneic stem cell transplantation should be considered for all young and fit patients in first complete remission.