The following is a summary of “Survival impact of hypoxia-inducible factor-1 alpha (HIF-1α) in Nucleophosmin1 mutated acute myeloid leukemia,” published in the December 2024 issue of Hematology by Chanswangphuwana et al. 

Nucleophosmin1 (NPM1) mutated acute myeloid leukemia (AML) without FLT3-ITD is classified as a favorable risk and responds well to cytarabine. Hypoxia-inducible factor-1 alpha (HIF-1α) promotes leukemic cell survival and may contribute to cytarabine resistance. 

Researchers conducted a prospective study to evaluate the impact of HIF-1α expression on NPM1 mutated AML without FLT3-ITD. 

They evaluated HIF-1α expression in bone marrow samples from 29 newly diagnosed patients with NPM1⁺FLT3-ITD⁻ normal karyotype AML using immunohistochemistry. They analyzed the correlation between HIF-1α expression and relapse-free survival (RFS) after induction chemotherapy and cytarabine consolidation. 

The results showed that HIF-1α staining with a Golgi body pattern was observed in 34.5% of patients and strong cytoplasmic HIF-1α expression in 58.6%. Both patterns were linked to increased relapse (P = 0.048) and inferior (RFS, P = 0.042). Multivariate analysis identified extramedullary disease at diagnosis as an independent prognostic factor for poor RFS (HR 3.82; 95% CI 1.26–11.55, P = 0.018). Golgi body or strong cytoplasmic HIF-1α expression showed a trend toward worse RFS (HR 3.56; 95% CI 1.00–12.69, P = 0.050). 

They concluded that high HIF-1α expression was a potential baseline prognostic biomarker for poor RFS and cytarabine resistance in NPM1⁺FLT3-ITD⁻ AML. Further studies with larger cohorts were recommended to validate these findings. 

Source: link.springer.com/article/10.1007/s00277-024-06124-w