IDH1 R132 (R132H/C/G/L/S) activating mutation in AML — ~6-10% prevalence. Ivosidenib (AGI...
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | RF-AML-IDH1-MUT-ACTIONABLE |
|---|---|
| Tipo | Señal de alerta |
| Situación | reviewed 2026-04-27 | pending_clinical_signoff |
| Enfermedades | DIS-AML |
| Fuentes | SRC-ELN-AML-2022 SRC-ESMO-AML-2020 SRC-NCCN-AML-2025 |
Origen de la bandera roja
| Definición | IDH1 R132 (R132H/C/G/L/S) activating mutation in AML — ~6-10% prevalence. Ivosidenib (AGILE — addition to azacitidine 1L unfit-for-intensive: mEFS HR 0.33, mOS 24.0 vs 7.9 mo) is FDA-approved for ND-AML-IDH1 unfit; 7+3 + ivosidenib in fit patients per emerging data. Monotherapy approved R/R-AML. |
|---|---|
| Dirección clínica | intensificar |
| Categoría | high-risk-biology |
| Algoritmo de cambios | ALGO-AML-1L, ALGO-AML-2L |
Lógica de activación
{
"any_of": [
{
"finding": "idh1_r132h",
"value": true
},
{
"finding": "idh1_mutation",
"value": true
},
{
"finding": "idh1_status",
"value": "mutated"
},
{
"finding": "idh_mutation",
"value": "IDH1"
}
],
"type": "biomarker"
}
Notas
IHC (mIDH1-R132H antibody) is highly sensitive for the dominant R132H variant — used for first-pass screen. Other IDH1 variants (R132C, R132G, R132S, R132L) are rarer and IHC-negative — require NGS panel. Differentiation syndrome on ivosidenib (~25%) — monitor WBC, dyspnea, weight gain; dexamethasone treatment + hold IDH1i. AGILE trial: ivosidenib + azacitidine for unfit; 7+3 + ivosidenib emerging for fit (HOVON / NCCN-listed). Olutasidenib alternative (FDA-approved R/R-AML).
Utilizado por
Algoritmos
ALGO-AML-1L- ALGO-AML-1LALGO-AML-2L- ALGO-AML-2L
Indicación
IND-AML-RR-IDH1-OLUTASIDENIB- IND-AML-RR-IDH1-OLUTASIDENIB