b'NPM1Clinical InformationThe Nucleophosmin (NPM1) gene is one of the most Favorable prognosis: NPM1 mutation without FLT3 ITDcommonly mutated genes in acute myeloid leukemiaor with FLT3 ITD low(AML), occurring in about 35% of AML patients at diagnosis. 1 Intermediate prognosis: NPM1 mutation and FLT3 ITD high ; The vast majority of NPM1 mutations are insertions in exon- low12 occurring near the C-terminus of the protein that result NPM1without FLT3 ITD or with FLT3 ITD(without in cytoplasmic localization. 2Currently there are over 40adverse-risk genetic lesions)known NPM1 mutations, most of which will be detected Poor prognosis: NPM1 wild-type and FLT3 ITD highwith our assay.It is recommended that AML patients be screened for Clinical studies have found that NPM1 mutationsNPM1 mutations as an effort to assess prognosis and are associated with increased blast counts, higheraid in treatment decisions. Results from NPM1 and extramedullary involvement and increased plateletFLT3 mutational screening should be available within counts in AML. 3Furthermore, in the absence of a FLT3 ITD48 to 72 hours (at least in patients eligible for intensive mutation (or FLT3 ITD with a low ratio), NPM1 mutations arechemotherapy). Utilizing both NPM1 and FLT3associated with a favorable prognosis. 4(mutant:wild-type ratio) mutation status is the most common molecular method for stratification of theIt has been suggested that the identification of mutationsAML population.in both NPM1 and FLT3 genes allows for the stratification of the AML patients into three different prognostic groups:References1.Thiede C, et al. (2006) Prevalence and prognostic impact of NPM1 mutations in 1485 adult patients with acute myeloidleukemia (AML). Blood 107:4011-4020.Falini B. et al. (2007) Translocations and mutations involving the nucleophosmin (NPM1) gene in lymphomas and leukemias. 2. Haematologica 92(4):519-532.3.Dhner K, et al. (2005) Mutant nucleophosmin (NPM1) predicts favorable prognosis in younger adults with acute myeloidleukemia and normal cytogenetics: interaction with other gene mutations. Blood 106(12):3740-3746.4.Dhner H, et al. (2017) Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expertpanel. Blood 129:424-447.20'