Sara Javidiparsijani, Assistant Professor of Pathology at University of Calgary, shared a post on X:
“NPM1 mutation questions for experts:
1) AML patient, NL karyotype, trilineage dysplasia on the slide and with both STAG2 and NPM1 mutations, how to classify?
2) Patient with monocytosis, only 2% blasts and NPM1 mutation (VAF:25%), how to classify?”
Sanam Loghavi, Associate Professor of Pathology at MD Anderson Cancer Center, Medical Director of ECOG-ACRIN Leukemia Bank and Editor in Chief of Image Bank at the American Society of Hematology, added a comment to this post:
“As per current classification:
#1 is AML-NPM1m and considered favorable risk by ELN 2022 (assuming no FLT3 ITD); however there is a body of literature now including Curtis Lachowiez paper in Blood Cancer Discovery showing NPM1+MR don’t do as well. The Viny Lab is the authority on STAG2
#2 this is AML. I think it’s time we put this issue to rest. One could argue it may be sAML arising from CMML, but regardless, now it’s AML. Again, we show data in the paper below, and others have shown too. Blast count in NPM1c is irrelevant Prognosis may vary, depending on co-mutations.”
Title: Multimodal and Data-Driven Assessment of Myeloid Neoplasms Refines Classification across Disease States
Authors: Curtis A. Lachowiez, Georgios Asimomitis, Elsa Bernard, Sean M. Devlin, Yanis Tazi, Maria Creignou, Ulrich Germing, Norbert Gattermann, Amanda Gilkes, Ian Thomas, Lars Bullinger, Konstanze Döhner, Luca Malcovati, Jad Othman, Richard Dillon, Ann-Kathrin Eisfeld, Deedra Nicolet, Ghayas C. Issa, Naval Daver, Tapan M. Kadia, Courtney D. DiNardo, Farhad Ravandi, Guillermo Garcia-Manero, Guillermo Montalban-Bravo, Nigel Russell, Mario Cazzola, Hartmut Döhner, Brian J.P. Huntly, Robert P. Hasserjian, Eva Hellström-Lindberg, Elli Papaemmanuil, Sanam Loghavi
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