NUP98 Rearrangement Dynamics Predict Outcomes in Adult Patients With Acute Myeloid Leukemia Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: A Multicenter Real-World Study.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
BACKGROUND: Acute myeloid leukemia with NUP98 rearrangements (NUP98r) is associated with poor prognosis, and while allo-HSCT remains the primary curative approach, its efficacy in NUP98r patients is still uncertain. The prognostic impact of NUP98 fusion partners, accompanying genetic alterations, and NUP98r dynamics is unclear. METHODS: We retrospectively analyzed 56 adult patients with NUP98r AML undergoing allo-HSCT across multiple centers. Primary outcomes included overall survival (OS), disease-free survival (DFS), and cumulative incidence of relapse (CIR). RESULTS: The most common NUP98r were NUP98::HOXA9 and NUP98::NSD1. With a median follow-up of 755 days, the 2-year CIR, DFS, and OS rates were 28.4%, 69.8%, and 73.0%. Pre-transplant NUP98r status demonstrated no significant association with outcomes in complete remission patients, while nonremission status correlated with higher CIR and reduced survival. NUP98r positivity at 1 month post-HSCT predicted higher 2-year CIR (60.0% versus 21.5%, P = .013), reduced DFS (40.0% versus 78.5%, P = .008) and OS (40.0% versus 84.5%, P = .003). Outcomes worsened at 3 and 6 months, with 100% CIR in the NUP98r positive at 6 months. Multivariable analysis confirmed 1-month post-HSCT NUP98r positivity as an independent predictor of relapse and mortality, whereas pre-transplant NUP98r status lacked prognostic significance. CONCLUSIONS: Patients with detectable NUP98r post-HSCT showed higher relapse risk and mortality, indicating the necessity for early molecular surveillance and early intervention trials in this high-risk subgroup.