Adult acute myeloid leukemia patients with NUP98 rearrangement have frequent cryptic translocations and unfavorable outcome

Abstract

Acute myeloid leukemia (AML) with NUP98 rearrangement (AML-NUP98) has been uncommonly reported in adults, and its incidence in our institution is ∼2.5%. There were four men and five women with a median age of 49 years, among which six cases were de novo AML and three were therapy-related. Five cases were AML with minimal differentiation or without maturation, followed by four with monocytic differentiation. NUP98 rearrangement was confirmed in all cases by FISH, and five cases showed cryptic translocations. The median overall survival (OS) was 13 months, shorter than that of AML-NPM1 (p < 0.05), and similar to that in AML-KMT2A patients in our institution. The unfavorable OS was further confirmed by comparing to AML patients in TCGA database. In conclusion, adult AML-NUP98 is associated with cryptic translocations and an unfavorable outcome. Our study suggests that incorporating the NUP98 probe into AML FISH panels are warranted to improve clinical management.

Keywords:

• Acute myeloid leukemia
• adult
• NUP98 rearrangement
• cryptic translocation

Author contribution

WX, CMH and HL collected the clinical data. WX and PL performed the data analysis; WX drafted the manuscript. SO, FY, JW, GF and TA contributed to the clinical data. PWR, JD, RS, SH, RDP, SRM reviewed and revised the manuscript.

Disclosure statement

All authors report no conflict of interest and funding disclosures.