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NPM1 mutation (most commonly type-A: c.860_863dupTCTG / p.W288fs) in AML — ~30% of adult...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-AML-NPM1-MUT-FAVORABLE
TypeSignal d’alerte
Étatreviewed 2026-04-27 | pending_clinical_signoff
MaladiesDIS-AML
SourcesSRC-ELN-AML-2022 SRC-ESMO-AML-2020 SRC-NCCN-AML-2025

Origine du drapeau rouge

DéfinitionNPM1 mutation (most commonly type-A: c.860_863dupTCTG / p.W288fs) in AML — ~30% of adult AML; ~50% of cytogenetically normal AML. ELN-2022 favorable risk when NPM1-mutated WITHOUT FLT3-ITD; standard 7+3 induction first-line (no upfront alloHCT in CR1; consolidation HiDAC × 3-4 cycles is curative-intent). MRD qPCR (NPM1-mut transcript) for monitoring.
Direction cliniquedésescalade
Catégoriehigh-risk-biology
Algorithme de décalageALGO-AML-1L

Logique de déclenchement

{
  "all_of": [
    {
      "any_of": [
        {
          "finding": "npm1_mutation",
          "value": true
        },
        {
          "finding": "npm1_status",
          "value": "mutated"
        },
        {
          "finding": "npm1_type_a",
          "value": true
        }
      ]
    },
    {
      "any_of": [
        {
          "finding": "flt3_itd",
          "value": false
        },
        {
          "finding": "flt3_itd_status",
          "value": "negative"
        }
      ]
    }
  ],
  "type": "composite_score"
}

Notes

De-escalate direction reflects "do NOT intensify to upfront alloHCT" — favorable-risk patients receive standard chemo with curative intent; alloHCT reserved for MRD-positive after consolidation OR early relapse. NPM1-mut + FLT3-ITD high-allelic-ratio downgrades to intermediate (and now adverse per ELN-2022 if NPM1-WT). MRD-NPM1 qPCR threshold ≥2-log reduction = molecular response; MRD-positive after consolidation → consider alloHCT. Menin inhibitors (revumenib, ziftomenib) — investigational R/R NPM1-mut. RF coexists with RF-AML-FLT3-ACTIONABLE (different axes — NPM1+FLT3-ITD case fires both).

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Algorithmes