Related Experiment Video
Updated: Apr 21, 2026
07:35
Selecting Multiple Biomarker Subsets with Similarly Effective Binary Classification Performances
Published on: October 11, 2018
8.1K
APL-like subset within NPM1-mutated AML: A distinct immunophenotype correlating with early vascular complications
Francesco Mannelli1,2,3, Francesca Crupi1,2,3, Sara Bencini4
1Dipartimento di Medicina Sperimentale e Clinica Università di Firenze Firenze Italy.
Hemasphere
|April 20, 2026
Summary
A subtype of NPM1-mutated acute myeloid leukemia (AML) with an APL-like immunophenotype shows increased vascular events and early death. This APL-like AML subtype is linked to IDH1/2 mutations and requires tailored clinical strategies.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- NPM1-mutated acute myeloid leukemia (AML) comprises a heterogeneous group of patients.
- A subset of NPM1-mutated AML exhibits an immunophenotype similar to acute promyelocytic leukemia (APL-like).
Purpose of the Study:
- To investigate the clinical and molecular characteristics of NPM1-mutated AML with an APL-like immunophenotype.
- To assess the association between the APL-like immunophenotype and vascular events, early death, and molecular mutations.
Main Methods:
- Retrospective multicenter study of 384 NPM1-mutated AML patients.
- Immunophenotypic analysis to identify APL-like cases.
- Evaluation of coagulopathy markers, vascular events, and early mortality.
- Analysis of IDH1/2 mutations.
- Validation in an independent cohort of 302 NPM1-mutated AML patients from the AMLSG 09-09 trial.
Main Results:
- 24.7% of NPM1-mutated AML patients displayed an APL-like immunophenotype.
- APL-like cases showed significant coagulopathy abnormalities and a higher incidence of vascular events (30.5% vs. 10.1%) and early death (6.3% vs. 0.35%) within 30 days.
- APL-like immunophenotype was independently associated with vascular-related early death (HR=19).
- IDH1/2 mutations were more frequent in APL-like (68.3%) versus non-APL-like (18.3%) cases.
- In the validation cohort, APL-like immunophenotype correlated with early events but not mortality, likely due to protocol interventions.
Conclusions:
- The APL-like immunophenotype in NPM1-mutated AML identifies a subset at high risk for early vascular complications.
- This subtype is associated with IDH1/2 mutations, suggesting distinct molecular drivers.
- Findings support the need for tailored clinical strategies to mitigate vascular event risk in APL-like NPM1-mutated AML.
