In conclusion, in this small cohort of patients with an adverse clinical outcome, the prevailing pattern of detectability and undetectability of NPM1 mut with stable co-mutations at similar VAFs prompted us to hypothesize that NPM1 mutation can occur very early before the expansion of a dominating preleukemic clonal hematopoiesis, and in this case, clonal hematopoiesis becomes undetectable at remission but persists along with NPM1mut at a deeper level on chemo-resistant leukemic stem cell clones that may drive/be responsible for subsequent relapse. Therefore, relapse may rely on the persistence of a chemo-resistant leukemic stem cell clone that harbors both pre-leukemic and NPM1 mutations and persists at very low level in the absence of an evident clonal hematopoiesis.
Sequential next generation sequencing analysis in homogeneously treated low risk NPM1-mutated acute myeloid leukemia with an adverse clinical outcome
Arcaini L.;
2022-01-01
Abstract
In conclusion, in this small cohort of patients with an adverse clinical outcome, the prevailing pattern of detectability and undetectability of NPM1 mut with stable co-mutations at similar VAFs prompted us to hypothesize that NPM1 mutation can occur very early before the expansion of a dominating preleukemic clonal hematopoiesis, and in this case, clonal hematopoiesis becomes undetectable at remission but persists along with NPM1mut at a deeper level on chemo-resistant leukemic stem cell clones that may drive/be responsible for subsequent relapse. Therefore, relapse may rely on the persistence of a chemo-resistant leukemic stem cell clone that harbors both pre-leukemic and NPM1 mutations and persists at very low level in the absence of an evident clonal hematopoiesis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.