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Query: UMLS:C0023418 (
leukemia
)
93,477
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Nucleophosmin (NPM) is a nucleocytoplasmic shuttling protein involved in
leukemia
-associated chromosomal translocations, and it regulates the alternate reading frame (ARF)-p53 tumor-suppressor pathway. Recently, it has been demonstrated that mutations of the
NPM1
gene alter the protein at its C-terminal, causing its cytoplasmic localization. Cytoplasmic NPM was detected in 35% of adult patients with primary non-French-American-British (FAB) classification M3 acute myeloid leukemia (AML), associated mainly with normal karyotype. We evaluated the prevalence of the
NPM1
gene mutation in non-M3 childhood AML patients enrolled in the ongoing Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP-AML02) protocol in Italy.
NPM1
mutations were found in 7 (6.5%) of 107 successfully analyzed patients.
NPM1
-mutated patients carried a normal karyotype (7/26, 27.1%) and were older in age. Thus, the
NPM1
mutation is a frequent abnormality in AML patients without known genetic marker; the mutation may represent a new target to monitor minimal residual disease in AML and a potential candidate for alternative and targeted treatments.
...
PMID:Nucleophosmin mutations in childhood acute myelogenous leukemia with normal karyotype. 1587 Jan 72
Mutations in the Nucleophosmin (
NPM1
) gene have been recently described to occur in about one-third of acute myeloid leukemias (AML) and represent the most frequent genetic alteration currently known in this subset. These mutations generate an elongated NPM1 protein that localizes aberrantly in the cytoplasm. In analogy with Flt3 alterations,
NPM1
mutations are mostly detectable in AML with normal karyotype and their recognition may be relevant to identify distinct response to treatment. Hence, in addition to conventional karyotyping and RT-PCR of fusion genes, combined analysis of both Flt3 and
NPM1
mutations will be increasingly relevant in the genetic diagnosis work-up of AML. We developed a multiplex RT-PCR assay followed by capillary electrophoresis to simultaneously analyze
NPM1
and Flt3 gene alterations (NFmPCR assay). The assay was validated in leukemic cell RNAs extracted from 38 AML patients, which had been previously characterized for Flt3 status by conventional RT-PCR. Direct sequencing of
NPM1
RT-PCR products was carried out in 15 cases to verify results obtained by capillary electrophoresis. Both
NPM1
sequencing and conventional RT-PCR Flt3 results showed 100% concordance with the results of the NFmPCR assay. We suggest that this assay may be introduced in routine analysis of genetic alterations in AML.
Leukemia
2005 Aug
PMID:Simultaneous detection of NPM1 and FLT3-ITD mutations by capillary electrophoresis in acute myeloid leukemia. 1597 51
Recently, somatic mutations of the nucleophosmin gene (
NPM1
), which alter the subcellular localization of the product, have been reported in acute myeloid leukemia (AML). We analyzed the clinical significance of
NPM1
mutations in comparison with cytogenetics, FLT3, NRAS, and TP53 mutations, and a partial tandem duplication of the MLL gene (MLL-TD) in 257 patients with AML. We found
NPM1
mutations, including 4 novel sequence variants, in 64 of 257 (24.9%) patients.
NPM1
mutations were associated with normal karyotype and with internal tandem duplication (ITD) and D835 mutations in FLT3, but not with other mutations. In 190 patients without the M3 French-American-British (FAB) subtype who were treated with the protocol of the Japan Adult
Leukemia
Study Group, multivariate analyses showed that the
NPM1
mutation was a favorable factor for achieving complete remission but was associated with a high relapse rate. Sequential analysis using 39 paired samples obtained at diagnosis and relapse showed that
NPM1
mutations were lost at relapse in 2 of the 17 patients who had
NPM1
mutations at diagnosis. These results suggest that the
NPM1
mutation is not necessarily an early event during leukemogenesis or that
leukemia
clones with
NPM1
mutations are sensitive to chemotherapy.
...
PMID:Clinical characteristics and prognostic implications of NPM1 mutations in acute myeloid leukemia. 1599 85
The assignment with chromosome banding techniques of the breakpoints of the recurrent translocation t(3;5) which leads to
NPM1
/MLF1 gene fusion in myeloid malignancies has not been unequivocal. In order to assess whether this is due to uncertainty in interpretation of the observed banding pattern or whether it reflects true genomic heterogeneity, we decided to analyze the breakpoint positions using fluorescence in situ (FISH) techniques in eight patients with myeloid malignancies and rearrangements of chromosomes 3 and 5. In three patients, colocalization of the
NPM1
and MLF1 spanning BACs was demonstrated and
NPM1
/MLF1 fusion shown by PCR in one while in the remaining cases breakpoints were located outside the
NPM1
and MLF1 loci. Interestingly, loss of a copy of the
NPM1
gene was found in three of these latter patients. This findings suggest that haploinsufficiency of
NPM1
may play a role in subtypes of myelodysplasias and leukemias.
Leukemia
2006 Feb
PMID:Loss of the NPM1 gene in myeloid disorders with chromosome 5 rearrangements. 1634 Oct 35
Mutations in exon 12 of the nucleophosmin (
NPM1
) gene occur in about 60% of adult AML with normal karyotype. By exploiting a specific feature of
NPM1
mutants, that is insertion at residue 956 or deletion/insertion at residue 960, we developed highly sensitive, real-time quantitative (RQ) polymerase chain reaction (PCR) assays, either in DNA or RNA, that are specific for various
NPM1
mutations. In all 13 AML patients carrying
NPM1
mutations at diagnosis, cDNA RQ-PCR showed >30 000 copies of
NPM1
-mutated transcript. A small or no decrease in copies was observed in three patients showing partial or no response to induction therapy. The number of
NPM1
-mutated copies was markedly reduced in 10 patients achieving complete hematological remission (five cases: <100 copies; five cases: 580-5046 copies). In four patients studied at different time intervals, the number of
NPM1
copies closely correlated with clinical status and predicted impending hematological relapse in two. Thus, reliable, sensitive RQ-PCR assays for
NPM1
mutations can now monitor and quantify MRD in AML patients with normal karyotype and
NPM1
gene mutations.
Leukemia
2006 Jun
PMID:Quantitative assessment of minimal residual disease in acute myeloid leukemia carrying nucleophosmin (NPM1) gene mutations. 1654 Nov 44
C-terminal somatic mutations in nucleophosmin (NPM), a nucleolar shuttling protein that binds p53 and p19(Arf), were recently described in karyotypically normal acute myeloid leukaemia (AML). We analysed primary marrow samples from 150 patients with various chronic myeloid disorders for mutations in the
NPM1
gene encoding NPM.
NPM1
mutations (tetranucleotide duplication) were detected in three patients, all of whom had chronic myelomonocytic
leukaemia
(CMML) and a short (<1 year) survival, with rapid progression to overt AML. All other patients were
NPM1
-wild type in the region analysed. In conclusion, C-terminal NPM mutations are uncommon in chronic myeloid neoplasia, but if present may represent an evolving leukaemic clone.
...
PMID:C-terminal nucleophosmin mutations are uncommon in chronic myeloid disorders. 1670 39
Nucleophosmin (NPM) is a nucleolar phosphoprotein that plays multiple roles in ribosome assembly and transport, cytoplasmic-nuclear trafficking, centrosome duplication and regulation of p53. In hematological malignancies, the
NPM1
gene is frequently involved in chromosomal translocation, mutation and deletion. The
NPM1
gene on 5q35 is translocated with the anaplastic lymphoma kinase (ALK) gene in anaplastic large cell lymphoma with t(2;5). The MLF1 and RARA genes are fused with
NPM1
in myelodysplastic syndrome and acute myeloid leukemia (AML) with t(3;5) and acute promyelocytic leukemia with t(5;17), respectively. In each fused protein, the N-terminal NPM portion is associated with oligomerization of a partner protein leading to altered signal transduction or transcription. Recently, mutations of exon 12 have been found in a significant proportion of de novo AML, especially in those with a normal karyotype. Mutant NPM is localized aberrantly in the cytoplasm, but the molecular mechanisms for
leukemia
remain to be studied. Studies of knock-out mice have revealed new aspects regarding
NPM1
as a tumor-suppressor gene. This review focuses on the clinical significance of the
NPM1
gene in hematological malignancies and newly discovered roles of NPM associated with oncogenesis.
...
PMID:Nucleophosmin: a versatile molecule associated with hematological malignancies. 1698 70
The nucleophosmin (
NPM1
) gene encodes for a multifunctional nucleocytoplasmic shuttling protein that is localized mainly in the nucleolus.
NPM1
mutations occur in 50% to 60% of adult acute myeloid leukemia with normal karyotype (AML-NK) and generate NPM mutants that localize aberrantly in the leukemic-cell cytoplasm, hence the term NPM-cytoplasmic positive (NPMc+ AML). Cytoplasmic NPM accumulation is caused by the concerted action of 2 alterations at mutant C-terminus, that is, changes of tryptophan(s) 288 and 290 (or only 290) and creation of an additional nuclear export signal (NES) motif. NPMc+ AML shows increased frequency in adults and females, wide morphologic spectrum, multilineage involvement, high frequency of FLT3-ITD, CD34 negativity, and a distinct gene-expression profile. Analysis of mutated NPM has important clinical and pathologic applications. Immunohistochemical detection of cytoplasmic NPM predicts
NPM1
mutations and helps rationalize cytogenetic/molecular studies in AML.
NPM1
mutations in absence of FLT3-ITD identify a prognostically favorable subgroup in the heterogeneous AML-NK category. Due to their frequency and stability,
NPM1
mutations may become a new tool for monitoring minimal residual disease in AML-NK. Future studies should focus on clarifying how NPM mutants promote
leukemia
, integrating NPMc+ AML in the upcoming World Health Organization
leukemia
classification, and eventually developing specific antileukemic drugs.
...
PMID:Acute myeloid leukemia carrying cytoplasmic/mutated nucleophosmin (NPMc+ AML): biologic and clinical features. 1700 39
To explore the validity and prognostic significance of minimal residual disease detection by quantitative polymerase chain reaction (qPCR) in patients of acute myeloid leukemia (AML) bearing Nucleophosmin (
NPM1
) mutations, we quantified mutants in 194 bone marrow samples from 38 patients with a median follow-up time of 20.6 months. Following induction chemotherapy, a median of 2.78 log decline in mutant copy number was observed. Relapse was always accompanied by significant increase of mutant numbers (P<0.001). After achieving complete remission (CR), the mutant copy number was significantly higher in patients with subsequent relapse than in those remaining in continuous CR (P<0.001). Presence of detectable mutants after treatment predicted relapse if no further chemotherapy was administered. Furthermore, the patients with any rise of mutant signals during serial follow-up had 3.2-fold increase of relapse risk compared to those with persistently low or undetectable signals (P<0.001). Patients who could achieve mutant reduction to <0.1% of internal control had significantly longer overall survival (OS) (P=0.004) and relapse-free survival (RFS) (P<0.001). Failure to achieve 2 logs of reduction after consolidation predicted shorter OS (P=0.01) and RFS (P=0.001). In conclusion, qPCR monitoring may have prognostic impact in AML patients with
NPM1
mutations.
Leukemia
2007 May
PMID:Clinical implications of minimal residual disease monitoring by quantitative polymerase chain reaction in acute myeloid leukemia patients bearing nucleophosmin (NPM1) mutations. 1736 Dec 27
The FIP1L1-PDGFRA fusion gene has been described in patients with eosinophilia-associated myeloproliferative disorders (Eos-MPD). Here, we report on seven FIP1L1-PDGFRA-positive patients who presented with acute myeloid leukemia (AML, n=5) or lymphoblastic T-cell non-Hodgkin-lymphoma (n=2) in conjunction with AML or Eos-MPD. All patients were male, the median age was 58 years (range, 40-66). AML patients were negative for common mutations of FLT3, NRAS,
NPM1
, KIT, MLL and JAK2; one patient revealed a splice mutation of RUNX1 exon 7. Patients were treated with imatinib (100 mg, n=5; 400 mg, n=2) either as monotherapy (n=2), as maintenance treatment after intensive chemotherapy (n=3) or in overt relapse 43 and 72 months, respectively, after primary diagnosis and treatment of FIP1L1-PDGFRA-positive disease (n=2). All patients are alive, disease-free and in complete hematologic and complete molecular remission after a median time of 20 months (range, 9-36) on imatinib. The median time to achievement of complete molecular remission was 6 months (range, 1-14). We conclude that all eosinophilia-associated hematological malignancies should be screened for the presence of the FIP1L1-PDGFRA fusion gene as they are excellent candidates for treatment with tyrosine kinase inhibitors even if they present with an aggressive phenotype such as AML.
Leukemia
2007 Jun
PMID:Recurrent finding of the FIP1L1-PDGFRA fusion gene in eosinophilia-associated acute myeloid leukemia and lymphoblastic T-cell lymphoma. 1737 85
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