{"entity":{"id":"npm1-mutation","kind":"biomarker","name":"NPM1 mutation","aka":["NPM1 mutation","NPM1-mutated AML","NPM1c","mutated NPM1","NPM1 type A","NPM1mut"],"tldr":"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.","asOf":"2026-09-23","links":[{"label":"Komzifti prescribing information (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b650f696-3391-4274-8b55-a5f5e9d04769"},{"label":"Revuforj prescribing information (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6eb3cdbc-0e74-477d-82d6-3bb172d3f63f"}],"tags":["biomarker","aml"],"related":["flt3-itd","idh1-r132"],"cancers":["aml","aml-npm1-kmt2a"],"sections":[],"technologies":[],"targets":[],"drugs":["ziftomenib","revumenib"],"companies":[],"institutions":[],"pathways":[],"terms":["mrd","molecular-response"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"target":"npm1","measurement":"sequencing-variant","scoringRule":{"text":"An NPM1 exon 12 frameshift insertion (type A, B, D or other) by PCR or sequencing of blood or marrow; quantitative PCR of the mutant transcript is used for residual disease.","quote":"KOMZIFTI is indicated for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible nucleophosmin 1 ( NPM1 ) mutation who have no satisfactory alternative treatment options","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b650f696-3391-4274-8b55-a5f5e9d04769","sourceLabel":"Komzifti prescribing information"},"thresholds":[{"value":"Susceptible NPM1 mutation, relapsed or refractory","drugId":"ziftomenib","cancerId":"aml-npm1-kmt2a","regulator":"FDA","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b650f696-3391-4274-8b55-a5f5e9d04769","quote":"KOMZIFTI is indicated for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible nucleophosmin 1 ( NPM1 ) mutation who have no satisfactory alternative treatment options","status":"current"},{"value":"NPM1 mutation, relapsed or refractory","drugId":"revumenib","cancerId":"aml-npm1-kmt2a","regulator":"FDA","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6eb3cdbc-0e74-477d-82d6-3bb172d3f63f","quote":"REVUFORJ is indicated for the treatment of relapsed or refractory acute myeloid leukemia with a susceptible nucleophosmin 1 ( NPM1 ) mutation in adult and pediatric patients 1 year and older who have no satisfactory alternative treatment options.","status":"current"}],"tests":["foundationone-heme","neotype-profiles"],"assays":[],"companionDiagnostics":[],"forPatient":"An NPM1 mutation at diagnosis is, on its own, good news: these leukaemias respond well to chemotherapy, and the mutation can be tracked in your blood to catch relapse early. If the leukaemia does come back, ziftomenib or revumenib tablets are on label. Whether you also have a FLT3-ITD changes the plan, so both results are read together."},"route":"/biomarkers/npm1-mutation/","neighbours":{"biomarker":[{"id":"cd33-expression","kind":"biomarker","name":"CD33 expression (CD33-positive)","route":"/biomarkers/cd33-expression/"},{"id":"flt3-itd","kind":"biomarker","name":"FLT3-ITD (internal tandem duplication)","route":"/biomarkers/flt3-itd/"},{"id":"idh1-r132","kind":"biomarker","name":"IDH1 R132 mutation","route":"/biomarkers/idh1-r132/"}],"cancer":[{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"},{"id":"aml-npm1-kmt2a","kind":"cancer","name":"NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia","route":"/cancers/aml-npm1-kmt2a/"}],"drug":[{"id":"revumenib","kind":"drug","name":"Revumenib","route":"/drugs/revumenib/"},{"id":"ziftomenib","kind":"drug","name":"Ziftomenib","route":"/drugs/ziftomenib/"}],"term":[{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"},{"id":"molecular-response","kind":"term","name":"Molecular response (MMR, MR4, treatment-free remission)","route":"/terms/molecular-response/"}],"target":[{"id":"npm1","kind":"target","name":"NPM1 mutation","route":"/targets/npm1/"}]}}