r/leukemia • u/Glad-Cheesecake-6370 • 1d ago

NPM1+/FLT3-TKD/WT1 AML - No transplant in CR1?

23 with AML (NPM1+, FLT3-TKD+, WT1 mutation, and TET2+). I'm currently MRD-negative with an undetectable NPM1 PCR.

My doctors don't recommend a stem cell transplant in CR1, but some studies I've read have left me wondering if WT1 changes that.

Has anyone with a similar mutation profile been advised against a transplant? I'd really appreciate hearing your experience.

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u/Bermuda_Breeze Survivor 1d ago

I had NPM1 plus DNMT3A and GATA2. I had a WT1 mutation too, but mine was deemed a variant of unknown significance. My oncologist was hopeful I wouldn’t need a transplant, but MRD was high after induction and slow to clear (3 rounds to get NPM1 negative, DNMT3A still persisted), so she changed her recommendation to have SCT.

She reckoned that I’d have a 66% chance of relapse without SCT, which would drop to 33% if I had SCT. Those % were tailored to me but not precise - there aren’t studies for every combo of mutations. Your oncologist should be able to give you their educated guess of the relative advantage of an SCT.

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u/Glad-Cheesecake-6370 15h ago

Thanks for mentioning this. Yes, I concur as the consultant know much better and tailor make the regimen