# NPM1 mutation

Source: https://onco.cc/biomarkers/npm1-mutation/  
OnCo record `npm1-mutation` (Biomarker). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

NPM1 mutations, found in about a third of adult acute myeloid leukaemias, misplace the nucleophosmin protein into the cytoplasm. They mean a better outlook without FLT3-ITD, a sensitive MRD marker, and since 2025 a targeted menin inhibitor.

## Summary

Frameshift insertions in NPM1 exon 12 (type A, TCTG, in about 80 percent) are detected by PCR or sequencing and the transcript is tracked as measurable residual disease. Ziftomenib (Komzifti, 2025) is labelled for relapsed or refractory AML with a susceptible NPM1 mutation and no satisfactory alternative; revumenib (Revuforj) gained an NPM1-mutated relapsed or refractory indication in 2025 alongside its KMT2A-rearranged one. NPM1-mutated AML without FLT3-ITD is favourable-risk in ELN 2022 and is often spared transplant in first remission if MRD clears.

## Fields

- Kind: Biomarker
- Last checked: 2026-09-23
- Also known as: NPM1 mutation; NPM1-mutated AML; NPM1c; mutated NPM1; NPM1 type A; NPM1mut
- Tags: biomarker; aml

## Sources

- Komzifti prescribing information (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b650f696-3391-4274-8b55-a5f5e9d04769
- Revuforj prescribing information (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6eb3cdbc-0e74-477d-82d6-3bb172d3f63f

## Connected records

- biomarkers: [CD33 expression (CD33-positive)](https://onco.cc/biomarkers/cd33-expression/), [FLT3-ITD (internal tandem duplication)](https://onco.cc/biomarkers/flt3-itd/), [IDH1 R132 mutation](https://onco.cc/biomarkers/idh1-r132/)
- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia](https://onco.cc/cancers/aml-npm1-kmt2a/)
- drugs: [Revumenib](https://onco.cc/drugs/revumenib/), [Ziftomenib](https://onco.cc/drugs/ziftomenib/)
- terms: [Minimal / molecular residual disease (MRD)](https://onco.cc/terms/mrd/), [Molecular response (MMR, MR4, treatment-free remission)](https://onco.cc/terms/molecular-response/)
- targets: [NPM1 mutation](https://onco.cc/targets/npm1/)

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JSON: https://onco.cc/api/v1/entities/npm1-mutation.json