High Frequency of Nucleophosmin Mutations in Thirty Two Iraqi Adult Patients with Acute Myeloid Leukemia
Ethar Kadhim Dhahir, Maysaa Abdul Razaq Dhahi

Abstract
Background: Genetic characterization of all AML patients at presentation is nowadays regarded as mandatory to determine treatment choices. In Iraq no previous study on genetic level that determine the frequency of NPM1mutations in adult AML patients was previously done and for this reason the current study was designed. Methods: Thirty two adult AML patients in addition to 15 healthy were enrolled in this study. The AML cases were classified according to the FAB classification. Molecular analysis for nucleophosmin mutations was done using Single Strand Confirmatory Polymorphism- Reverse transcriptase- Polymerase Chain Reaction with specific primers. Results: The NPM1 mutations were found in 46.88% of adult AML patients , whereas the control group showed absence of these mutations. The NPM1mutations were detected non significantly in older age and female gender AML patients, (P>0.05). Furthermore; patients with the NPM1 mutations showed lower blast cell % and higher platelet count as compared to non mutated cases, and were mainly FAB M1and M3, (P>0.05). Moreover, higher failure rate of induction therapy was found in adult AML patients without NPM1 mutations 55.55% as compared to NPM1 mutated patients 44.44% , but this finding was not significant, (P= 0.453). Conclusions: Molecular detection of NPM1 mutations in Iraqi adult AML patients was reported for the first time where the frequency of NPM1 mutations in adult AML patients was higher than that reported in different studies worldwide. NPM1 mutations were associated with good prognostic factors in AML as female gender, lower blast cell percent and higher rate of response to induction therapy thus , this mutation is can be considered in risk stratification of AML patients.

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