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Yaqoob A, Verma NK, Aziz RM. Optimizing Gene Selection and Cancer Classification with Hybrid Sine Cosine and Cuckoo Search Algorithm. J Med Syst 2024; 48:10. [PMID: 38193948 DOI: 10.1007/s10916-023-02031-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024]
Abstract
Gene expression datasets offer a wide range of information about various biological processes. However, it is difficult to find the important genes among the high-dimensional biological data due to the existence of redundant and unimportant ones. Numerous Feature Selection (FS) techniques have been created to get beyond this obstacle. Improving the efficacy and precision of FS methodologies is crucial in order to identify significant genes amongst complicated complex biological data. In this work, we present a novel approach to gene selection called the Sine Cosine and Cuckoo Search Algorithm (SCACSA). This hybrid method is designed to work with well-known machine learning classifiers Support Vector Machine (SVM). Using a dataset on breast cancer, the hybrid gene selection algorithm's performance is carefully assessed and compared to other feature selection methods. To improve the quality of the feature set, we use minimum Redundancy Maximum Relevance (mRMR) as a filtering strategy in the first step. The hybrid SCACSA method is then used to enhance and optimize the gene selection procedure. Lastly, we classify the dataset according to the chosen genes by using the SVM classifier. Given the pivotal role gene selection plays in unraveling complex biological datasets, SCACSA stands out as an invaluable tool for the classification of cancer datasets. The findings help medical practitioners make well-informed decisions about cancer diagnosis and provide them with a valuable tool for navigating the complex world of gene expression data.
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Affiliation(s)
- Abrar Yaqoob
- School of Advanced Sciences and Languages, VIT Bhopal University, Kothrikalan, Sehore, 466114, India.
| | - Navneet Kumar Verma
- School of Advanced Sciences and Languages, VIT Bhopal University, Kothrikalan, Sehore, 466114, India
| | - Rabia Musheer Aziz
- School of Advanced Sciences and Languages, VIT Bhopal University, Kothrikalan, Sehore, 466114, India
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Morotti A, Barale C, Sornatale M, Giugliano E, Muccio VE, Frascaroli C, Pautasso M, Fornari A, Russo I. Aberrant Platelet Aggregation as Initial Presentation of Essential Thrombocythemia: Failure of Entero-Coated Aspirin to Reduce Platelet Hyperactivation. Int J Mol Sci 2023; 25:176. [PMID: 38203347 PMCID: PMC10778871 DOI: 10.3390/ijms25010176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Essential thrombocythemia (ET) is a myeloproliferative neoplasm variant characterized by excessive production of platelets. Since the most common cause of mortality and morbidity in ET patients is thrombosis, the excessive production of platelets may cause thrombotic events. However, little is known about the function of platelets in ET. We report a female patient who presented as asymptomatic, without a remarkable medical history, and ET was diagnosed after an incidental finding of moderate thrombocytosis. Notably, together with thrombocytosis, an abnormal platelet phenotype was found for the presence of a massive, rapid and spontaneous formation of aggregates and platelet hypersensitivity to subthreshold concentrations of aggregating agonists. Bone marrow histopathological examination and genetic analysis with the JAK2 (V617F) gene mutation findings confirmed the initial suspicion of ET. Although the ET patient was placed on aspirin, the persistence of the platelet hyperactivation and hyperaggregability prompted a switch in antiplatelet medication from entero-coated (EC) to plain aspirin. As result, platelet hypersensitivity to agonists and spontaneous aggregation were no longer found. Collectively, our study demonstrates that platelet function analysis could be a reliable predictor of ET and that plain aspirin should be preferred over EC aspirin to attenuate platelet hyperreactivity.
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Affiliation(s)
- Alessandro Morotti
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole, 10, Orbassano, I-10043 Turin, Italy; (A.M.); (C.B.); (M.S.)
| | - Cristina Barale
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole, 10, Orbassano, I-10043 Turin, Italy; (A.M.); (C.B.); (M.S.)
| | - Michele Sornatale
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole, 10, Orbassano, I-10043 Turin, Italy; (A.M.); (C.B.); (M.S.)
| | - Emilia Giugliano
- Laboratory of Clinical and Microbiological Analyses, San Luigi Gonzaga Hospital, Orbassano, I-10043 Turin, Italy; (E.G.); (V.E.M.); (C.F.); (M.P.)
| | - Vittorio Emanuele Muccio
- Laboratory of Clinical and Microbiological Analyses, San Luigi Gonzaga Hospital, Orbassano, I-10043 Turin, Italy; (E.G.); (V.E.M.); (C.F.); (M.P.)
| | - Chiara Frascaroli
- Laboratory of Clinical and Microbiological Analyses, San Luigi Gonzaga Hospital, Orbassano, I-10043 Turin, Italy; (E.G.); (V.E.M.); (C.F.); (M.P.)
| | - Marisa Pautasso
- Laboratory of Clinical and Microbiological Analyses, San Luigi Gonzaga Hospital, Orbassano, I-10043 Turin, Italy; (E.G.); (V.E.M.); (C.F.); (M.P.)
| | - Alessandro Fornari
- Department of Oncology, Division of Pathology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, I-10043 Turin, Italy;
| | - Isabella Russo
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole, 10, Orbassano, I-10043 Turin, Italy; (A.M.); (C.B.); (M.S.)
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Chia YC, Siti Asmaa MJ, Ramli M, Woon PY, Johan MF, Hassan R, Islam MA. Molecular Genetics of Thrombotic Myeloproliferative Neoplasms: Implications in Precision Oncology. Diagnostics (Basel) 2023; 13:163. [PMID: 36611455 PMCID: PMC9818412 DOI: 10.3390/diagnostics13010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 01/06/2023] Open
Abstract
Classical BCR-ABL-negative myeloproliferative neoplasms (MPN) include polycythaemia vera, essential thrombocythaemia, and primary myelofibrosis. Unlike monogenic disorders, a more complicated series of genetic mutations are believed to be responsible for MPN with various degrees of thromboembolic and bleeding complications. Thrombosis is one of the early manifestations in patients with MPN. To date, the driver genes responsible for MPN include JAK2, CALR, MPL, TET2, ASXL1, and MTHFR. Affords have been done to elucidate these mutations and the incidence of thromboembolic events. Several lines of evidence indicate that mutations in JAK2, MPL, TET2 and ASXL1 gene and polymorphisms in several clotting factors (GPIa, GPIIa, and GPIIIa) are associated with the occurrence and prevalence of thrombosis in MPN patients. Some polymorphisms within XRCC1, FBG, F2, F5, F7, F12, MMP9, HPA5, MTHFR, SDF-1, FAS, FASL, TERT, ACE, and TLR4 genes may also play a role in MPN manifestation. This review aims to provide an insightful overview on the genetic perspective of thrombotic complications in patients with MPN.
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Affiliation(s)
- Yuh Cai Chia
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mat Jusoh Siti Asmaa
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Marini Ramli
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Peng Yeong Woon
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien 97004, Taiwan
| | - Muhammad Farid Johan
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Rosline Hassan
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Md Asiful Islam
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
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Mustafa AHM, Krämer OH. Pharmacological Modulation of the Crosstalk between Aberrant Janus Kinase Signaling and Epigenetic Modifiers of the Histone Deacetylase Family to Treat Cancer. Pharmacol Rev 2023; 75:35-61. [PMID: 36752816 DOI: 10.1124/pharmrev.122.000612] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/08/2022] [Accepted: 08/15/2022] [Indexed: 12/13/2022] Open
Abstract
Hyperactivated Janus kinase (JAK) signaling is an appreciated drug target in human cancers. Numerous mutant JAK molecules as well as inherent and acquired drug resistance mechanisms limit the efficacy of JAK inhibitors (JAKi). There is accumulating evidence that epigenetic mechanisms control JAK-dependent signaling cascades. Like JAKs, epigenetic modifiers of the histone deacetylase (HDAC) family regulate the growth and development of cells and are often dysregulated in cancer cells. The notion that inhibitors of histone deacetylases (HDACi) abrogate oncogenic JAK-dependent signaling cascades illustrates an intricate crosstalk between JAKs and HDACs. Here, we summarize how structurally divergent, broad-acting as well as isoenzyme-specific HDACi, hybrid fusion pharmacophores containing JAKi and HDACi, and proteolysis targeting chimeras for JAKs inactivate the four JAK proteins JAK1, JAK2, JAK3, and tyrosine kinase-2. These agents suppress aberrant JAK activity through specific transcription-dependent processes and mechanisms that alter the phosphorylation and stability of JAKs. Pharmacological inhibition of HDACs abrogates allosteric activation of JAKs, overcomes limitations of ATP-competitive type 1 and type 2 JAKi, and interacts favorably with JAKi. Since such findings were collected in cultured cells, experimental animals, and cancer patients, we condense preclinical and translational relevance. We also discuss how future research on acetylation-dependent mechanisms that regulate JAKs might allow the rational design of improved treatments for cancer patients. SIGNIFICANCE STATEMENT: Reversible lysine-ɛ-N acetylation and deacetylation cycles control phosphorylation-dependent Janus kinase-signal transducer and activator of transcription signaling. The intricate crosstalk between these fundamental molecular mechanisms provides opportunities for pharmacological intervention strategies with modern small molecule inhibitors. This could help patients suffering from cancer.
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Affiliation(s)
- Al-Hassan M Mustafa
- Department of Toxicology, University Medical Center, Mainz, Germany (A.-H.M.M., O.H.K.) and Department of Zoology, Faculty of Science, Aswan University, Aswan, Egypt (A.-H.M.M.)
| | - Oliver H Krämer
- Department of Toxicology, University Medical Center, Mainz, Germany (A.-H.M.M., O.H.K.) and Department of Zoology, Faculty of Science, Aswan University, Aswan, Egypt (A.-H.M.M.)
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La Spina E, Giallongo S, Giallongo C, Vicario N, Duminuco A, Parenti R, Giuffrida R, Longhitano L, Li Volti G, Cambria D, Di Raimondo F, Musumeci G, Romano A, Palumbo GA, Tibullo D. Mesenchymal stromal cells in tumor microenvironment remodeling of BCR-ABL negative myeloproliferative diseases. Front Oncol 2023; 13:1141610. [PMID: 36910610 PMCID: PMC9996158 DOI: 10.3389/fonc.2023.1141610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Chronic myeloproliferative neoplasms encompass the BCR-ABL1-negative neoplasms polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). These are characterized by calreticulin (CALR), myeloproliferative leukemia virus proto-oncogene (MPL) and the tyrosine kinase Janus kinase 2 (JAK2) mutations, eventually establishing a hyperinflammatory tumor microenvironment (TME). Several reports have come to describe how constitutive activation of JAK-STAT and NFκB signaling pathways lead to uncontrolled myeloproliferation and pro-inflammatory cytokines secretion. In such a highly oxidative TME, the balance between Hematopoietic Stem Cells (HSCs) and Mesenchymal Stromal Cells (MSCs) has a crucial role in MPN development. For this reason, we sought to review the current literature concerning the interplay between HSCs and MSCs. The latter have been reported to play an outstanding role in establishing of the typical bone marrow (BM) fibrotic TME as a consequence of the upregulation of different fibrosis-associated genes including PDGF- β upon their exposure to the hyperoxidative TME characterizing MPNs. Therefore, MSCs might turn to be valuable candidates for niche-targeted targeting the synthesis of cytokines and oxidative stress in association with drugs eradicating the hematopoietic clone.
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Affiliation(s)
- Enrico La Spina
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Sebastiano Giallongo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Cesarina Giallongo
- Department of Medical-Surgical Science and Advanced Technologies "Ingrassia", University of Catania, Catania, Italy
| | - Nunzio Vicario
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Andrea Duminuco
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Rosalba Parenti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Rosario Giuffrida
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Lucia Longhitano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giovanni Li Volti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Daniela Cambria
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Francesco Di Raimondo
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Alessandra Romano
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Giuseppe Alberto Palumbo
- Department of Medical-Surgical Science and Advanced Technologies "Ingrassia", University of Catania, Catania, Italy
| | - Daniele Tibullo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Tekin TO, Karis D, Ates Alkan F, Cetin G, Ercan AM. Evaluation of trace elements in essential thrombocytosis and reactive thrombocytosis. J Trace Elem Med Biol 2022; 73:127034. [PMID: 35839560 DOI: 10.1016/j.jtemb.2022.127034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/15/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Trace elements (TE) are vital for cellular mechanisms at biological, chemical and molecular levels. The effects of TE in diagnosis, progression and treatment of essential thrombocytosis (ET), which is one of the chronic myeloproliferative neoplasms is a rare clonal stem cell disease characterized by increased thrombocyte numbers with impaired function, have not been elucidated in detail yet. The aim of the present study was to investigate the effects of TE alterations in an ET model and the efficacy of TE in ET treatment protocol by means of a vast number of TE. METHODS Study groups were categorized as patients with ET diagnosis (ET group, n:30), patients with reactive thrombocytosis secondary to iron deficiency anemia (IDA-RT) (IDA-RT group, n:30) and healthy controls (HC group, n:30). Serum levels of copper (Cu), iron (Fe), cobalt (Co), chromium (Cr), aluminum (Al), silicon (Si), nickel (Ni), zinc (Zn), selenium (Se), manganese (Mn), boron (B) and magnesium (Mg) were analyzed utilizing inductively coupled plasma-optical emission spectrophotometer instrument (ICP-OES). Statistical analysis was evaluated using SPSS 23.0. RESULTS ET group had statistically higher serum levels of Co and Mg (p < 0.05), Ni and Mn (p < 0.001), and lower Si (p < 0.05) than IDA-RT group. ET group had statistically higher serum levels of Co and Mn (p < 0.05), and Ni (p < 0.001), and lower Al, Si and Se (p < 0.001) than HC group. Serum levels of Fe, Al and Se (p < 0.001), and Mg (p < 0.01), and Zn (p < 0.05) in IDA-RT group were significantly lower than HC group. CONCLUSION This novel study pointed out that alterations of many serum TE by means of both increment or decrement might have close relationship with mechanisms and complications of ET onset and follow-up. We consider that further research of TE would elucidate ethiopathogenesis and prognosis of ET. Thus, analysis of serum trace elements in essential thrombocytosis patients may be an important protocol by means of diagnosis, treatment and follow-up intervals.
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Affiliation(s)
- Tuba Ozkan Tekin
- Department of Hematology, Department of Internal Medicine, Faculty of Medicine, Bezmialem University, Fatih, Istanbul, Turkey
| | - Denizhan Karis
- Department of Biophysics, Faculty of Medicine, İstanbul University-Cerrahpasa, Fatih, Istanbul, Turkey.
| | - Fatma Ates Alkan
- Department of Biophysics, Faculty of Medicine, İstanbul University-Cerrahpasa, Fatih, Istanbul, Turkey
| | - Guven Cetin
- Department of Hematology, Department of Internal Medicine, Faculty of Medicine, Bezmialem University, Fatih, Istanbul, Turkey
| | - Alev Meltem Ercan
- Department of Biophysics, Faculty of Medicine, İstanbul University-Cerrahpasa, Fatih, Istanbul, Turkey
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Analysis of factors associated with the development of myelofibrosis in polycythemia vera and essential thrombocythemia patients: a single-center experience. J Hematop 2022. [DOI: 10.1007/s12308-022-00488-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Saito N, Yamauchi T, Kawano N, Ono R, Yoshida S, Miyamoto T, Kamimura T, Shultz LD, Saito Y, Takenaka K, Shimoda K, Harada M, Akashi K, Ishikawa F. Circulating CD34+ cells of primary myelofibrosis patients contribute to myeloid-dominant hematopoiesis and bone marrow fibrosis in immunodeficient mice. Int J Hematol 2022; 115:198-207. [PMID: 34773575 PMCID: PMC8905546 DOI: 10.1007/s12185-021-03239-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Primary myelofibrosis (PMF) is a clonal stem cell disorder characterized by myeloid dominant hematopoiesis and dysregulated proliferation of fibroblasts in the bone marrow. However, how these aberrant myeloid cells and fibroblasts are produced remains unclear. AIM AND METHODS In this study, we examined in vivo engraftment kinetics of PMF patient-derived CD34+ cells in immunecompromised NOD/SCID/IL2rgKO (NSG) mice. Engrafted human cells were analyzed with flow cytometry, and proliferation of fibroblastic cells and bone marrow fibrosis were assessed with the histo-pathological examination. RESULTS Transplantation of PMF patient-derived circulating CD34+ fractions into NSG newborns recapitulates clinical features of human PMF. Engraftment of human CD45+ leukocytes resulted in anemia and myeloid hyperplasia accompanied by bone marrow fibrosis by six months post-transplantation. Fibrotic bone marrow contained CD45-vimentin+ cells of both human and mouse origin, suggesting that circulating malignant CD34+ subsets contribute to myelofibrotic changes in PMF through direct and indirect mechanisms. CONCLUSION A patient-derived xenotransplantation (PDX) model of PMF allows in vivo examination of disease onset and propagation originating from immature CD34+ cells and will support the investigation of pathogenesis and development of therapeutic modalities for the disorder.
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Affiliation(s)
- Noriyuki Saito
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Hematology, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Takuji Yamauchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Noriaki Kawano
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Rintaro Ono
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Shuro Yoshida
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | | | | | - Yoriko Saito
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Katsuto Takenaka
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Kazuya Shimoda
- Division of Hematology, Diabetes, and Endocrinology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Mine Harada
- Karatsu Higashimatsuura Medical Center, Karatsu, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Fumihiko Ishikawa
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
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Gou P, Zhang W, Giraudier S. Insights into the Potential Mechanisms of JAK2V617F Somatic Mutation Contributing Distinct Phenotypes in Myeloproliferative Neoplasms. Int J Mol Sci 2022; 23:ijms23031013. [PMID: 35162937 PMCID: PMC8835324 DOI: 10.3390/ijms23031013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 12/19/2022] Open
Abstract
Myeloproliferative neoplasms (MPN) are a group of blood cancers in which the bone marrow (BM) produces an overabundance of erythrocyte, white blood cells, or platelets. Philadelphia chromosome-negative MPN has three subtypes, including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). The over proliferation of blood cells is often associated with somatic mutations, such as JAK2, CALR, and MPL. JAK2V617F is present in 95% of PV and 50–60% of ET and PMF. Based on current molecular dynamics simulations of full JAK2 and the crystal structure of individual domains, it suggests that JAK2 maintains basal activity through self-inhibition, whereas other domains and linkers directly/indirectly enhance this self-inhibited state. Nevertheless, the JAK2V617F mutation is not the only determinant of MPN phenotype, as many normal individuals carry the JAK2V617F mutation without a disease phenotype. Here we review the major MPN phenotypes, JAK-STAT pathways, and mechanisms of development based on structural biology, while also describing the impact of other contributing factors such as gene mutation allele burden, JAK-STAT-related signaling pathways, epigenetic modifications, immune responses, and lifestyle on different MPN phenotypes. The cross-linking of these elements constitutes a complex network of interactions and generates differences in individual and cellular contexts that determine the phenotypic development of MPN.
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Affiliation(s)
- Panhong Gou
- Laboratoire UMRS-1131, Ecole doctorale 561, Université de Paris, 75010 Paris, France
- INSERM UMR-S1131, Hôpital Saint-Louis, 75010 Paris, France
- Correspondence: (P.G.); (S.G.)
| | - Wenchao Zhang
- BFA, UMR 8251, CNRS, Université de Paris, 75013 Paris, France;
| | - Stephane Giraudier
- Laboratoire UMRS-1131, Ecole doctorale 561, Université de Paris, 75010 Paris, France
- INSERM UMR-S1131, Hôpital Saint-Louis, 75010 Paris, France
- Service de Biologie Cellulaire, Hôpital Saint-Louis, AP-HP, 75010 Paris, France
- Correspondence: (P.G.); (S.G.)
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Hamed G, Abdelmaksoud M, Abdulrahman D, El Sakhawy Y. Frequency of JAK2V617F and CALR somatic mutations in Egyptian patients with thrombocytosis: relation with clinical and hematological phenotype. THE EGYPTIAN JOURNAL OF HAEMATOLOGY 2022. [DOI: 10.4103/ejh.ejh_66_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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11
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Enawgaw B, Aynalem M, Melku M, Asrie F, Abebe M, Yalew A, Bekele T, Mesfin N, Ayalew M, Shiferaw E. Hematological malignancies in the Northwest Ethiopia. PLoS One 2021; 16:e0260639. [PMID: 34852010 PMCID: PMC8635328 DOI: 10.1371/journal.pone.0260639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The effect of malignant diseases is increasing globally, particularly in developing countries as shown by recent cancer statistics from the world health organization reports. It is anticipated that with an increase in life expectancy consequent upon the improved standard of living and increasing urbanization, the burden of hematological malignancies in sub-Saharan Africa particularly in Ethiopia is likely to increase recently. Therefore, this study was aimed to determine the incidence and trend of hematological malignancy in Northwest Ethiopia. METHODS A facility-based retrospective study was conducted from 2015 to 2019 at the University of Gondar and Bahir-Dar Felegehiwot comprehensive specialized hospitals. Hematological malignancy data were collected by using a data collection sheet that was consisted of patients' socio-demography, clinical, and laboratory data. Then, data were entered into Epi-info 3.5.1 and exported to SPSS version 20 for analysis. Skewness and kurtosis were used to check data distribution. Descriptive statistics were summarized as percentages, means, and standard deviations of background variables, and the trend were analyzed. RESULTS In this study, a total of 1,342 study participants were included. The mean age of study participants was 41.49 ± 16.3 years with a range of 1 to 92 years. About 58.3%, 52.2%, and 80% of the cases were observed among males, 18-45 age group, and urban residences, respectively. Of the total cases, 92.9% and 7.1% were lymphoma and leukemia, respectively. On the other hand, from lymphoma cases, 72.3% and 27.7% were HL and NHL, respectively while from leukemic cases, 61.1%, 23.2, 6.3%, 4.2%, and 5.3% were CLL, ALL, CML, AML, and other HM types, respectively. In this study, there was no trend. CONCLUSION We concluded that lymphoma was the dominant type of hematological malignancy observed in northwest Ethiopia. The study indicated that the majority of cases were observed among male, urban residents, and adult populations aged 18-45 years. Therefore, special focus should be given to the highly affected population. Further, a prospective cohort study should be conducted for a better understanding of the prevalence and associated factors to it.
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Affiliation(s)
- Bamlaku Enawgaw
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
| | - Melak Aynalem
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
| | - Mulugeta Melku
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
| | - Fikir Asrie
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
| | - Molla Abebe
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
| | - Aregawi Yalew
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
| | - Tiruzer Bekele
- University of Gondar, College of Medicine and Health Science, School of Medicine, Department of Pathology, Gondar, Ethiopia
| | - Nebiyu Mesfin
- University of Gondar, College of Medicine and Health Science, School of Medicine, Department of Internal Medicine, Gondar, Ethiopia
| | - Mulugeta Ayalew
- University of Gondar, College of Medicine and Health Science, School of Medicine, Unit of Pediatric Hematology Oncology, Gondar, Ethiopia
| | - Elias Shiferaw
- University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, Gondar, Ethiopia
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12
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Quirino MG, Macedo LC, Pagnano KBB, Pagliarini-E-Silva S, Sell AM, Visentainer JEL. Toll-like receptor gene polymorphisms in patients with myeloproliferative neoplasms. Mol Biol Rep 2021; 48:4995-5001. [PMID: 34191235 DOI: 10.1007/s11033-021-06238-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/16/2021] [Indexed: 12/26/2022]
Abstract
Toll-like receptors (TLRs) are a family of transmembrane receptors whose signaling control cellular processes of cell proliferation, survival, apoptosis, angiogenesis, remodeling, and repair of tissues. Polymorphisms in TLR genes can change the balance between pro and anti-inflammatory cytokines, modulating the risk of infection, chronic inflammation, and cancer. Although many studies have demonstrated the direct involvement of TLR signaling in the benefit of tumor cells in certain cancers, little is known about the influence of these gene polymorphisms on myeloproliferative neoplasms (MPNs). In this context, the objective of the study was to investigate a possible association between the TLR polymorphisms and the development of MPNs. 167 patients diagnosed with MPN and 222 healthy controls from the same region were evaluated. Genomic DNA was extracted and the TLR2 (rs5743708), TLR4 (rs4986790, rs4986791), TLR9 (rs5743836, rs187084) and JAK2V617F polymorphisms were genotyped by PCR-RFLP. The statistical analysis was performed by OpenEpi and SNPstat software. The JAK2V617F mutation was found in 68.32% of patients. TLR9-1486C/T CT genotype was less frequent in patients with polycythemia vera (PV) (OR 0.39, 95% CI 0.20-0.78, P = 0.025). When haplotype frequencies were analyzed, -1237T/-1486C (TLR9) was also less frequent in men (OR 0.58, 95% CI 0.36-0.94) and JAK negative men patients (OR 0.43, 95% CI 0.21-0.88). We can infer that the TLR9-1486 CT genotype could be associated with protection for PV and the TLR9-1237T/-1486C haplotype, protection for men, as well as for JAK negative men patients with MPN. There were no associations between TLR2 and TLR4 gene polymorphisms and MPN.
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Affiliation(s)
- Marília Gonçalves Quirino
- Graduate Program in Biosciences and Physiopathology of the State University of Maringá, Av. Colombo 5790, bloco T20, sala 109, Maringá, PR, CEP: 87020-900, Brazil
| | - Luciana Conci Macedo
- Graduate Program in Biosciences and Physiopathology of the State University of Maringá, Av. Colombo 5790, bloco T20, sala 109, Maringá, PR, CEP: 87020-900, Brazil
| | | | | | - Ana Maria Sell
- Graduate Program in Biosciences and Physiopathology of the State University of Maringá, Av. Colombo 5790, bloco T20, sala 109, Maringá, PR, CEP: 87020-900, Brazil
| | - Jeane Eliete Laguila Visentainer
- Graduate Program in Biosciences and Physiopathology of the State University of Maringá, Av. Colombo 5790, bloco T20, sala 109, Maringá, PR, CEP: 87020-900, Brazil.
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13
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Chia YC, Islam MA, Hider P, Woon PY, Johan MF, Hassan R, Ramli M. The Prevalence of TET2 Gene Mutations in Patients with BCR- ABL-Negative Myeloproliferative Neoplasms (MPN): A Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:3078. [PMID: 34203097 PMCID: PMC8235080 DOI: 10.3390/cancers13123078] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 12/19/2022] Open
Abstract
Multiple recurrent somatic mutations have recently been identified in association with myeloproliferative neoplasms (MPN). This meta-analysis aims to assess the pooled prevalence of TET2 gene mutations among patients with MPN. Six databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science and Embase) were searched for relevant studies from inception till September 2020, without language restrictions. The eligibility criteria included BCR-ABL-negative MPN adults with TET2 gene mutations. A random-effects model was used to estimate the pooled prevalence with 95% confidence intervals (CIs). Subgroup analyses explored results among different continents and countries, WHO diagnostic criteria, screening methods and types of MF. Quality assessment was undertaken using the Joanna Briggs Institute critical appraisal tool. The study was registered with PROSPERO (CRD42020212223). Thirty-five studies were included (n = 5121, 47.1% female). Overall, the pooled prevalence of TET2 gene mutations in MPN patients was 15.5% (95% CI: 12.1-19.0%, I2 = 94%). Regional differences explained a substantial amount of heterogeneity. The prevalence of TET2 gene mutations among the three subtypes PV, ET and MF were 16.8%, 9.8% and 15.7%, respectively. The quality of the included studies was determined to be moderate-high among 83% of the included studies. Among patients with BCR-ABL-negative MPN, the overall prevalence of TET2 gene mutations was 15.5%.
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Affiliation(s)
- Yuh Cai Chia
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (Y.C.C.); (M.F.J.); (R.H.)
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (Y.C.C.); (M.F.J.); (R.H.)
| | - Phil Hider
- Department of Population Health, University of Otago, Christchurch 8140, New Zealand;
| | - Peng Yeong Woon
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien 97004, Taiwan;
| | - Muhammad Farid Johan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (Y.C.C.); (M.F.J.); (R.H.)
| | - Rosline Hassan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (Y.C.C.); (M.F.J.); (R.H.)
| | - Marini Ramli
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (Y.C.C.); (M.F.J.); (R.H.)
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14
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Alshemmari SH, Rajan R, Ameen R, Almazyad M. Analysis of Common Driver Mutations in Philadelphia-Negative Myeloproliferative Neoplasms. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:483-488. [PMID: 33858806 DOI: 10.1016/j.clml.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Philadelphia-negative myeloproliferative neoplasms (MPNs) are a group of hematopoietic stem cell disorders that include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). This study examines the driver mutations among patients with MPNs in Kuwait. PATIENTS AND METHODS This study was a retrospective review of 942 MPN cases with a driver mutation from July 2007 to June 2019 to examine their demographic, clinical, and laboratory attributes. RESULTS The annual incidence of MPNs is 1.6 per 100,000 persons, and ET is the most common subtype. The median age of our cohort was 55 years, and the patients were predominantly male. We found that the most frequent gene mutation of MPNs in our cohort was the JAK2V617F mutation, which was present in 90% of cases, followed by the CALR exon 9, MPLW515L/K, and JAK2 exon 12 mutations. In our cohort, thrombotic events were observed in 18.7% of cases. CONCLUSION Although Philadelphia-negative MPNs are rare hematologic malignancies, thrombosis is a relatively common initial presentation. The JAK2V617F mutation was the driver mutation in the majority of patients with MPN.
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Affiliation(s)
- Salem H Alshemmari
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
| | - Reshmi Rajan
- Department of Hematology, Kuwait Cancer Center, Shuwiakh, Jabriya
| | - Reem Ameen
- Department of Medical Laboratory Sciences, Faculty of Allied Sciences, Kuwait University, Jabriya, Kuwait
| | - Mazyad Almazyad
- Seventh Year Medical Student, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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15
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Baik R, Wyman SK, Kabir S, Corn JE. Genome editing to model and reverse a prevalent mutation associated with myeloproliferative neoplasms. PLoS One 2021; 16:e0247858. [PMID: 33661998 PMCID: PMC7932127 DOI: 10.1371/journal.pone.0247858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/15/2021] [Indexed: 12/26/2022] Open
Abstract
Myeloproliferative neoplasms (MPNs) cause the over-production of blood cells such as erythrocytes (polycythemia vera) or platelets (essential thrombocytosis). JAK2 V617F is the most prevalent somatic mutation in many MPNs, but previous modeling of this mutation in mice relied on transgenic overexpression and resulted in diverse phenotypes that were in some cases attributed to expression level. CRISPR-Cas9 engineering offers new possibilities to model and potentially cure genetically encoded disorders via precise modification of the endogenous locus in primary cells. Here we develop "scarless" Cas9-based reagents to create and reverse the JAK2 V617F mutation in an immortalized human erythroid progenitor cell line (HUDEP-2), CD34+ adult human hematopoietic stem and progenitor cells (HSPCs), and immunophenotypic long-term hematopoietic stem cells (LT-HSCs). We find no overt in vitro increase in proliferation associated with an endogenous JAK2 V617F allele, but co-culture with wild type cells unmasks a competitive growth advantage provided by the mutation. Acquisition of the V617F allele also promotes terminal differentiation of erythroid progenitors, even in the absence of hematopoietic cytokine signaling. Taken together, these data are consistent with the gradually progressive manifestation of MPNs and reveals that endogenously acquired JAK2 V617F mutations may yield more subtle phenotypes as compared to transgenic overexpression models.
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Affiliation(s)
- Ron Baik
- Innovative Genomics Institute, University of California, Berkeley, CA, United States of America
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, United States of America
- New York University School of Medicine, New York, NY, United States of America
| | - Stacia K. Wyman
- Innovative Genomics Institute, University of California, Berkeley, CA, United States of America
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, United States of America
| | - Shaheen Kabir
- Innovative Genomics Institute, University of California, Berkeley, CA, United States of America
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America
- * E-mail: (JEC); (SK)
| | - Jacob E. Corn
- Innovative Genomics Institute, University of California, Berkeley, CA, United States of America
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, United States of America
- * E-mail: (JEC); (SK)
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16
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Nomura H, Iwato K, Fujiwara M, Takano Y, Arima J. The Efficacy of Imatinib Mesylate in the Treatment of a Rare Lytic Bone Lesion Caused by Hypereosinophilic Syndrome/Chronic Eosinophilic Leukemia: A Case Report. JBJS Case Connect 2021; 10:e0126. [PMID: 32224679 DOI: 10.2106/jbjs.cc.19.00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We report a patient with hypereosinophilia-associated massive osteolytic lesion of the sacrum who was admitted to our hospital. Genetic analysis revealed that atypical eosinophilic cells were positive for FIP1-like-1-platelet-derived growth factor receptor-alpha (FIP1L1-PDGFRA) fusion gene. Treatment was initiated with oral administration of imatinib mesylate. The patient responded rapidly to this medication with a marked reduction in eosinophilia both from the peripheral blood and FIP1L1-PDGFRA fusion gene in the bone marrow within 2 weeks, followed by gradual osteosclerotic repair of the sacrum. CONCLUSIONS This case study found that the drug imatinib proved very effective in the treatment of this rare condition.
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Affiliation(s)
- Hiroshi Nomura
- Department of Orthopaedic Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Koji Iwato
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Megumu Fujiwara
- Department of Pathology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Yugo Takano
- Department of Orthopaedic Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Junichi Arima
- Department of Orthopaedic Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
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17
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Chia YC, Ramli M, Woon PY, Johan MF, Hassan R, Islam MA. WITHDRAWN: Molecular genetics of thrombotic myeloproliferative neoplasms: Implications in precision oncology. Genes Dis 2021. [DOI: 10.1016/j.gendis.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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18
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Palandri F, Mora B, Gangat N, Catani L. Is there a gender effect in polycythemia vera? Ann Hematol 2021; 100:11-25. [PMID: 33006021 PMCID: PMC7782364 DOI: 10.1007/s00277-020-04287-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
In recent times, there has been a growing interest in understanding the impact of gender on disease biology and clinical outcomes in Philadelphia-negative chronic myeloproliferative neoplasms. Among those, polycythemia vera (PV) is characterized by increased thrombotic risk, systemic symptoms, and overall reduced survival. Here, we aim to summarize data on whether and to what extent female sex can affect PV biology and outcome. To this end, we will discuss the latest acquisitions in terms of pathogenesis, diagnosis, epidemiology, clinical presentation and symptoms burden, thrombotic risk and related treatment strategies, and prognosis in female patients affected by PV.
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Affiliation(s)
- Francesca Palandri
- Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Barbara Mora
- Hematology, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | | | - Lucia Catani
- Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
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19
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Kim SY, Bae SH, Bang SM, Eom KS, Hong J, Jang S, Jung CW, Kim HJ, Kim HY, Kim MK, Kim SJ, Mun YC, Nam SH, Park J, Won JH, Choi CW. The 2020 revision of the guidelines for the management of myeloproliferative neoplasms. Korean J Intern Med 2021; 36:45-62. [PMID: 33147902 PMCID: PMC7820646 DOI: 10.3904/kjim.2020.319] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/07/2020] [Indexed: 02/07/2023] Open
Abstract
In 2016, the World Health Organization revised the diagnostic criteria for myeloproliferative neoplasms (MPNs) based on the discovery of disease-driving genetic aberrations and extensive analysis of the clinical characteristics of patients with MPNs. Recent studies have suggested that additional somatic mutations have a clinical impact on the prognosis of patients harboring these genetic abnormalities. Treatment strategies have also advanced with the introduction of JAK inhibitors, one of which has been approved for the treatment of patients with myelofibrosis and those with hydroxyurea-resistant or intolerant polycythemia vera. Recently developed drugs aim to elicit hematologic responses, as well as symptomatic and molecular responses, and the response criteria were refined accordingly. Based on these changes, we have revised the guidelines and present the diagnosis, treatment, and risk stratification of MPNs encountered in Korea.
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Affiliation(s)
- Sung-Yong Kim
- Division of Hematology, Department of Internal Medicine, Konkuk University Medical Center, Seoul,
Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu,
Korea
| | - Soo-Mee Bang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Ki-Seong Eom
- Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Junshik Hong
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Chul Won Jung
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Hee-Jin Kim
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Ho Young Kim
- Department of Internal Medicine, Hallym University Medical Center, Anyang,
Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu,
Korea
| | - Soo-Jeong Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
Korea
| | - Yeung-Chul Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul,
Korea
| | - Seung-Hyun Nam
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul,
Korea
| | - Jinny Park
- Division of Hematology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon,
Korea
| | - Jong-Ho Won
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul,
Korea
| | - Chul Won Choi
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Seoul,
Korea
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20
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Allahverdi N, Yassin M, Ibrahim M. Environmental Factors, Lifestyle Risk Factors, and Host Characteristics Associated With Philadelphia Negative Myeloproliferative Neoplasm: A Systematic Review. Cancer Control 2021; 28:10732748211046802. [PMID: 34645293 PMCID: PMC8521755 DOI: 10.1177/10732748211046802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell disorders characterized by the overproduction of mature myeloid cells and are often associated with an acquired genetic mutation of Janus Kinase2V617F. Various epidemiological studies have indicated associations between environmental factors, lifestyle factors, and host characteristics with developing MPNs. This review aims to collect and summarize the existing information on these risk factors and establish their association with pathogenesis MPNs. Medline, Embase, PubMed, and grey literature were systematically searched using key terms for MPNs, and epidemiological study designs, that is, cross-sectional studies, case-control, and cohort, that investigated the risk factors for MPNs published were identified. Out of the 4621 articles identified, 20 met the selection criteria and were included in this review. Heterogeneity, study reliability, and bias were assessed. A significant association was found between smoking and the development of MPNs. This relationship has been explained by the substantial increase in several proinflammatory mediators and systematic oxidative stress causing hyperstimulation of myeloid compartments leading to the development of MPNs. Obesity was modestly linked with an increased risk of MPNs. The underlying mechanisms have been linked to changes in endocrine, metabolic, and inflammatory systems. No strong association was found between exposure to hazardous substances, that is, benzene and MPNs, but further investigation on the effects of increased levels and duration of exposure on hematopoietic stem cells will be beneficial. Unique individual and host variations have been determined as a modifier of disease pathogenesis and phenotype variations. There is a higher incidence rate of females developing MPNs, specifically ET, than males with higher PV incidence. Therefore, gender contributes to the heterogeneity in myeloproliferative neoplasm. Studies identified as part of this review are very diverse. Thus, further in-depth assessment to explore the role of these etiological factors associated with MPNs is warranted.
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Affiliation(s)
- Niloofar Allahverdi
- Research Specialist, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Yassin
- Hematology Consultant, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Ibrahim
- Professor of Social & Administrative Pharmacy, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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21
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TET2 rs1548483 SNP Associating with Susceptibility to Molecularly Annotated Polycythemia Vera and Primary Myelofibrosis. J Pers Med 2020; 10:jpm10040259. [PMID: 33271790 PMCID: PMC7711989 DOI: 10.3390/jpm10040259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background: The complexity of myeloproliferative neoplasms (MPNs) cannot be characterized by acquired somatic mutations alone. Individual genetic background is thought to contribute to the development of MPNs. The aim of our study was to assess the association between the TET2 rs1548483 single nucleotide polymorphism (SNP) and the susceptibility to polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF) or chronic myeloid leukemia (CML). Methods: We evaluated the TET2 rs1548483 SNP through real-time PCR in 1601 MPN patients out of which 431 with PV, 688 with TE, 233 with PMF, 249 with CML and 197 controls. We included only patients with a molecularly proven driver mutation, such as JAK2 V617F, CALR or BCR-ABL1. Results: Significant association between TET2 rs154843 variant allele and JAK2 V617F-positive PV and PMF (OR = 1.70; 95% CI: 1.01–2.91; p-value = 0.046, and OR = 2.04; 95% CI: 1.10–3.77; p-value = 0.024, respectively), and type 2 CALR-positive PMF (OR = 2.98; 95% CI: 1.12–7.93; p-value = 0.035) was noted. Conclusions: The TET2 rs1548483 SNP is associated with the susceptibility to molecularly annotated PV and PMF.
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22
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Büyükaşık Y, Ali R, Turgut M, Saydam G, Yavuz AS, Ünal A, Ar MC, Ayyıldız O, Altuntaş F, Okay M, Çiftçiler R, Meletli Ö, Soyer N, Mastanzade M, Güven Z, Soysal T, Karakuş A, Yiğenoğlu TN, Uçar B, Gökçen E, Tuğlular T. Patterns of Hydroxyurea Prescription and Use in Routine Clinical Management of Polycythemia Vera: A Multicenter Chart Review Study. Turk J Haematol 2020; 37:177-185. [PMID: 32075363 PMCID: PMC7463219 DOI: 10.4274/tjh.galenos.2020.2019.0431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: This study aimed to evaluate real-life data on patterns of hydroxyurea prescription/use in polycythemia vera (PV). Materials and Methods: This retrospective chart review study included PV patients who had received hydroxyurea therapy for at least 2 months after PV diagnosis. Data were collected from 10 representative academic medical centers. Results: Of 657 patients, 50.9% were in the high-risk group (age ≥60 years and/or history of thromboembolic event). The median duration of hydroxyurea therapy was 43.40 months for all patients; 70.2% of the patients had ongoing hydroxyurea therapy at last follow-up. Hydroxyurea was discontinued in 22.4% of the patients; the most common reason was death (38.5%). The predicted time until hydroxyurea discontinuation was 187.8 months (standard error: ±21.7) for all patients. This duration was shorter in females (140.3±37.7 vs. 187.8±29.7) (p=0.08). This trend was also observed in surviving patients aged ≥50 years at hydroxyurea initiation (122.2±12.4 vs. 187.8±30.7, p=0.03). Among the patients who were still on hydroxyurea therapy, 40.3% had a hematocrit concentration of ≥45% at their last follow-up visit, and the rate of patients with at least one elevated blood cell count was 67.8%. Conclusion: Hydroxyurea prescription patterns and treatment aims are frequently not in accordance with the guideline recommendations. Its discontinuation rate is higher in females.
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Affiliation(s)
- Yahya Büyükaşık
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Rıdvan Ali
- Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Güray Saydam
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Akif Selim Yavuz
- İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Ali Ünal
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Muhlis Cem Ar
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Fevzi Altuntaş
- Yıldırım Beyazıt University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey,Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
| | - Müfide Okay
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Rafiye Çiftçiler
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Özgür Meletli
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Nur Soyer
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Metban Mastanzade
- İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Zeynep Güven
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Teoman Soysal
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Abdullah Karakuş
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Tuğçe Nur Yiğenoğlu
- Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
| | | | | | - Tülin Tuğlular
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
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Yu J, Shi X, Yang C, Bullova P, Hong CS, Nesvick CL, Dmitriev P, Pacak K, Zhuang Z, Cao H, Li L. A novel germline gain-of-function HIF2A mutation in hepatocellular carcinoma with polycythemia. Aging (Albany NY) 2020; 12:5781-5791. [PMID: 32235007 PMCID: PMC7185130 DOI: 10.18632/aging.102967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 01/27/2020] [Indexed: 01/04/2023]
Abstract
Hypoxia-inducible factors (HIFs) regulate oxygen sensing and expression of genes involved in angiogenesis and erythropoiesis. Polycythemia has been observed in patients with hepatocellular carcinoma (HCC), but the underlying molecular basis remains unknown. Liver tissues from 302 HCC patients, including 104 with polycythemia, were sequenced for HIF2A mutations. A germline HIF2A mutation was detected in one HCC patient with concurrent polycythemia. Three additional family members carried this mutation, but none exhibited polycythemia or were diagnosed with HCC. The gain-of-function mutation resulted in a HIF-2α protein that was transcribed normally but resistant to degradation. HIF-2α target genes EDN1, EPO, GNA14, and VEGF were significantly upregulated in the tumor bed but not in the surrounding liver tissue. Polycythemia resolved upon total resection of the tumor tissue. This newly described HIF2A mutation may promote HCC oncogenesis.
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Affiliation(s)
- Jiong Yu
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou City, China
| | - Xiaowei Shi
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou City, China
| | - Chunzhang Yang
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Health (NIH), Bethesda, MD 20892, USA
| | - Petra Bullova
- Department of Molecular Medicine, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Christopher S. Hong
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Health (NIH), Bethesda, MD 20892, USA
| | - Cody L. Nesvick
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Health (NIH), Bethesda, MD 20892, USA
| | - Pauline Dmitriev
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Health (NIH), Bethesda, MD 20892, USA
| | - Karel Pacak
- Department of Molecular Medicine, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Zhengping Zhuang
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Health (NIH), Bethesda, MD 20892, USA
| | - Hongcui Cao
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou City, China
| | - Lanjuan Li
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou City, China
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24
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Lin X, Huang H, Chen P. Retrospective analysis of the clinical features of 172 patients with BCR-ABL1-negative chronic myeloproliferative neoplasms. Mol Cytogenet 2020; 13:8. [PMID: 32095159 PMCID: PMC7027207 DOI: 10.1186/s13039-020-0471-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/15/2020] [Indexed: 12/13/2022] Open
Abstract
Background To explore the clinical features of the patients with BCR-ABL1-negative chronic myeloproliferative neoplasms (MPNs) in our hospital and to reveal the unique features of BCR-ABL1-negative MPNs patients in our center. Methods Retrospective analysis of routine karyotype analysis results, driver gene mutations and other related clinical parameters of 172 patients with newly diagnosed BCR-ABL1-negative MPNs who were admitted to our hospital between October 2013 and June 2018. Results (1) The rate of karyotypic abnormalities were 25, 6.3 and 2.9% in primary myelofibrosis (PMF), polycythemia vera (PV) and essential thrombocythemia (ET) patients, respectively. (2) The mutation rate of JAK2-V617F was 62.5%, and that of the CALR, MPL and EZH2 genes was 4.2% in PMF. The mutation rates of JAK2-V617F and JAK2-12exon were 91.3 and 1.3% in PV, respectively. The mutation rates of JAK2-V617F and CALR were 69.1 and 11.8% in ET, respectively. (3) Patients with JAK2-V617F mutation than with the wild-type gene were more often female in PMF (P = 0.027); had higher peripheral blood white blood cell (WBC) counts (P = 0.006), platelet (PLT) count (P = 0.001) and splenomegaly (P < 0.05) in PV; and had higher WBC (P = 0.001), hemoglobin concentrations (P = 0.001), lower PLT (P = 0.037), splenomegaly and endogenous coagulopathy (P < 0.05) in ET. (4) Among the PV and ET patients, those with thrombus were older than those in the nonthrombotic group. Conclusion PMF patients have more chromosomal abnormalities than PV and ET patients, and the effect of driver mutations on the clinical features of patients with MPNs differs among the three subtypes.
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Affiliation(s)
- Xiaolan Lin
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 350000, Xinquan Rd, Fuzhou, Fujian China
| | - Huifang Huang
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 350000, Xinquan Rd, Fuzhou, Fujian China
| | - Ping Chen
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 350000, Xinquan Rd, Fuzhou, Fujian China
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25
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Breccia M, Baratè C, Benevolo G, Bonifacio M, Elli EM, Guglielmelli P, Maffioli M, Malato A, Mendicino F, Palumbo GA, Pugliese N, Rossi E, Rumi E, Sant'Antonio E, Ricco A, Tiribelli M, Palandri F. Tracing the decision-making process for myelofibrosis: diagnosis, stratification, and management of ruxolitinib therapy in real-word practice. Ann Hematol 2020; 99:65-72. [PMID: 31832751 PMCID: PMC6944647 DOI: 10.1007/s00277-019-03847-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
The management of patients with myelofibrosis (MF) has dramatically changed since the introduction of ruxolitinib as a tailored treatment strategy. However, the perceptions about the use of this drug in clinical practice remain, at times, a matter of discussion. We conducted a survey about the diagnostic evaluation, prognostic assessment, and management of ruxolitinib in real-life clinical practice in 18 Italian hematology centers. At diagnosis, most hematologists do not use genetically or molecularly inspired score systems to assess prognosis, mainly due to scarce availability of next-generation sequencing (NGS) methodology, with NGS conversely reserved only for a subset of lower-risk MF patients with the aim of possibly improving the treatment strategy. Some common points in the management of ruxolitinib were 1) clinical triggers for ruxolitinib therapy, regardless of risk category; 2) evaluation of infectious risk before the starting of the drug; and 3) schedule of monitoring during the first 12 weeks with the need, in some instances, of supportive treatment. Further development of international recommendations and insights will allow the achievement of common criteria for the management of ruxolitinib in MF, before and after treatment, and for the definition of response and failure.
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Affiliation(s)
- Massimo Breccia
- Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University, Rome, Italy.
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Giulia Benevolo
- Hematology, Città della Salute e della Scienza, Turin, Italy
| | | | - Elena Maria Elli
- Hematology Division and Bone Marrow Transplant Unit, ASST Monza, Ospedale San Gerardo, Monza, Italy
| | - Paola Guglielmelli
- Center of Research and Innovation of Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | | | - Alessandra Malato
- Division of Hematology and Bone Marrow Transplant, Villa Sofia-Cervello Hospital, 90146, Palermo, Italy
| | - Francesco Mendicino
- Hematology Unit, Department of Hemato-Oncology, Ospedale Annunziata, Via San Martino, snc -, 87100, Cosenza, Italy
| | - Giuseppe Alberto Palumbo
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Elena Rossi
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elisa Rumi
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Emanuela Sant'Antonio
- Department of Oncology, Division of Hematology, Azienda USL Toscana Nord Ovest, Lucca, Italy
- Medical Genetics, University of Siena, Siena, Italy
| | - Alessandra Ricco
- Department of Emergency and Organ Transplantation (DETO), Hematology Section, University of Bari, Bari, Italy
| | - Mario Tiribelli
- Division of Hematology and Bone Marrow Transplantation, Department of Medical Area, University of Udine, Udine, Italy
| | - Francesca Palandri
- Institute of Hematology "L. and A. Seràgnoli", Sant'Orsola-Malpighi University Hospital, Bologna, Italy
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26
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Courtier F, Garnier S, Carbuccia N, Guille A, Adélaide J, Chaffanet M, Hirsch P, Paz DL, Slama B, Vey N, Ugo V, Delhommeau F, Rey J, Birnbaum D, Murati A. Targeted molecular characterization shows differences between primary and secondary myelofibrosis. Genes Chromosomes Cancer 2020; 59:30-39. [PMID: 31340059 DOI: 10.1002/gcc.22789] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION In BCR-ABL1-negative myeloproliferative neoplasms, myelofibrosis (MF) is either primary (PMF) or secondary (SMF) to polycythemia vera or essential thrombocythemia. MF is characterized by an increased risk of transformation to acute myeloid leukemia (AML) and a shortened life expectancy. METHODS Because natural histories of PMF and SMF are different, we studied by targeted next generation sequencing the differences in the molecular landscape of 86 PMF and 59 SMF and compared their prognosis impact. RESULTS PMF had more ASXL1 (47.7%) and SRSF2 (14%) gene mutations than SMF (respectively 27.1% and 3.4%, P = .04). Poorer survival was associated with RNA splicing mutations (especially SRSF2) and TP53 in PMF (P = .0003), and with ASXL1 and TP53 mutations in SMF (P < .0001). These mutations of poor prognosis were associated with biological features of scoring systems (DIPSS and MYSEC-PM score). Mutations in TP53/SRSF2 in PMF or TP53/ASXL1 in SMF were more frequent as the risk of these scores increased. This allowed for a better stratification of MF patients, especially within the DIPSS intermediate-1 risk group (DIPSS) or the MYSEC-PM high risk group. AML transformation occurred faster in SMF than in PMF and patients who transformed to AML were more SRSF2-mutated and less CALR-mutated at MF sampling. CONCLUSIONS PMF and SMF have different but not specific molecular profiles and different prognosis depending on the molecular profile. This may be due to differences in disease history. Combining mutations and existing scores should improve prognosis assessment.
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Affiliation(s)
- Frédéric Courtier
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France.,Aix-Marseille Université, Marseille, France
| | - Séverine Garnier
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France
| | - Nadine Carbuccia
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France
| | - Arnaud Guille
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France
| | - José Adélaide
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France
| | - Max Chaffanet
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France.,Aix-Marseille Université, Marseille, France
| | - Pierre Hirsch
- Centre de Recherche Saint-Antoine CRSA, APHP, Hôpital Saint-Antoine, Sorbonne Université, Inserm, Paris, France
| | | | - Bohrane Slama
- Centre Hospitalier Général d'Avignon, Service d'Onco-Hématologie, France
| | - Norbert Vey
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Aix-Marseille Université, Marseille, France.,Département d'Hématologie, IPC, Marseille, France
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France
| | - François Delhommeau
- Centre de Recherche Saint-Antoine CRSA, APHP, Hôpital Saint-Antoine, Sorbonne Université, Inserm, Paris, France
| | - Jérome Rey
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Hématologie, IPC, Marseille, France
| | - Daniel Birnbaum
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France.,Aix-Marseille Université, Marseille, France
| | - Anne Murati
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, Marseille, France.,Département d'Oncologie Prédictive, Institut Paoli-Calmettes (IPC), Marseille, France.,Département de BioPathologie, IPC, Marseille, France
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27
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Jung SM, Jun H. Recurrent thrombosis of splanchnic and lower extremity arteries with essential thrombocythemia. SAGE Open Med Case Rep 2019; 7:2050313X19880079. [PMID: 31632677 PMCID: PMC6767714 DOI: 10.1177/2050313x19880079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/10/2019] [Indexed: 12/02/2022] Open
Abstract
Essential thrombocythemia is a myeloproliferative neoplasm characterized by
platelet aggregation and thrombosis. Clinically, essential thrombocythemia
increases the risk of both thrombosis and bleeding. Essential thrombocythemia is
more involved in micro- and small-sized arteries than in large arteries. Many
essential thrombocythemia patients exhibit various symptoms, including
microvascular thrombosis with acute coronary disease, digital ischemia, and
transient ischemic attack. This study reports a rare case of recurrent
thrombosis in relatively large vessels including splanchnic, lower extremity
arteries, and aorta in essential thrombocythemia. A 70-year-old woman was
admitted to the emergency room with abdominal pain and fever for a day. The
patient underwent three operations due to recurrent arterial thrombosis of
superior mesenteric, splenic, aorta, and lower extremities. She had recurrent
diarrhea and acute kidney injury because of short bowel syndrome after extensive
bowel resection. In conclusion, essential thrombocythemia patients aged >60
years and who have risk factors such as history of major ischemic events or
severe leukocytosis must be careful of thrombosis of the medium- and large-sized
arteries, including splanchnic and lower extremity arteries.
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Affiliation(s)
- Sung Min Jung
- Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, South Korea
| | - Heungman Jun
- Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, South Korea
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28
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An Intriguing Case of Eosinophilia with FIP1L1/PDGFRA Rearrangement Who Presented as Thrombotic Thrombocytopenic Purpura. Case Rep Hematol 2019; 2019:2820954. [PMID: 31737382 PMCID: PMC6815613 DOI: 10.1155/2019/2820954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/25/2019] [Accepted: 09/07/2019] [Indexed: 11/17/2022] Open
Abstract
Myeloid neoplasm with eosinophilia and FIP1-like-1-platelet-derived growth factor receptor-alpha (FIP1L1-PDGFRA) rearrangement is a multi-organ disease with diverse clinical presentation. Thrombotic thrombocytopenic purpura (TTP) is characterized by the concomitant occurrence of often severe thrombocytopenia, microangiopathic hemolytic anemia, and a variable degree of ischemic organ damage. To our knowledge, only one case of eosinophilia with FIP1L1-PDGFRA rearrangement presented as a case of thrombotic thrombocytopenic purpura reported in the literature. We herein report a case of a young male patient with hypereosinophilic syndrome and FIP1L1-PDGFRA rearrangement who presented with asthma, transient ischemic attacks (TIA), and confusion. He had an acquired TTP that was successfully treated with plasma exchanges (PLEX), corticosteroids, rituximab, and later with the addition of imatinib mesylate (Gleevec, Novartis). He remains in complete remission on imatinib 100 mg daily for more than 28 months of follow-up.
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29
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Heppner J, Nguyen LT, Guo M, Naugler C, Rashid-Kolvear F. Incidence of myeloproliferative neoplasms in Calgary, Alberta, Canada. BMC Res Notes 2019; 12:286. [PMID: 31126326 PMCID: PMC6534932 DOI: 10.1186/s13104-019-4321-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/18/2019] [Indexed: 12/12/2022] Open
Abstract
Objective The incidence of the combined myeloproliferative neoplasms (MPNs) was determined for a major Canadian city. Retrospective cases of MPN diagnoses (essential thrombocythemia, polycythemia vera, and primary myelofibrosis) between 2011 to 2015 were retrieved from the Southern Alberta Cancer Cytogenetics Laboratory’s database at Alberta Public Laboratories. Results An incidence rate of 2.05 cases per 100,000 person-years (95% CI 1.73–2.41) was determined, giving an age-standardized Canadian incidence of 2.71 cases per 100,000 person years (95% CI 2.63–2.78). MPN diagnoses occurred at a wide age range of 8–93 (median 66) and an age-dependent increase in incidence. Incidence rates for the MPNs are first reported here for a Canadian population.
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Affiliation(s)
- Jonathan Heppner
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Leonard Tu Nguyen
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maggie Guo
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Public Laboratories (formerly Calgary Laboratory Services), Calgary, AB, Canada
| | - Christopher Naugler
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Public Laboratories (formerly Calgary Laboratory Services), Calgary, AB, Canada.,Departments of Family Medicine and Community Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Fariborz Rashid-Kolvear
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Alberta Public Laboratories (formerly Calgary Laboratory Services), Calgary, AB, Canada. .,Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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30
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Guo Y, Zhou Y, Yamatomo S, Yang H, Zhang P, Chen S, Nimer SD, Zhao ZJ, Xu M, Bai J, Yang FC. ASXL1 alteration cooperates with JAK2V617F to accelerate myelofibrosis. Leukemia 2019; 33:1287-1291. [PMID: 30651633 DOI: 10.1038/s41375-018-0347-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/20/2018] [Accepted: 11/29/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Ying Guo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yuan Zhou
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Shohei Yamatomo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hui Yang
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Peng Zhang
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Shi Chen
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephen D Nimer
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zhizhuang Joe Zhao
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mingjiang Xu
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jie Bai
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
- Department of Hematology, the Second Hospital of Tianjin Medical University, Tianjin, China.
| | - Feng-Chun Yang
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA.
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31
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Moradabadi A, Farsinejad A, Khansarinejad B, Fatemi A. Development of a high resolution melting analysis assay for rapid identification of JAK2 V617F missense mutation and its validation. Exp Hematol Oncol 2019; 8:10. [PMID: 31165012 PMCID: PMC6489328 DOI: 10.1186/s40164-019-0134-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/20/2019] [Indexed: 01/09/2023] Open
Abstract
Background Myeloproliferative neoplasms (MPN) are heterogeneous diseases that classified by the presence of Philadelphia chromosome into Philadelphia chromosome negative (Ph-neg) and positive (Ph-pos) myeloproliferative neoplasms. In ph-neg group A somatic point mutation (c.1849G>T) in the JAK2 gene, part of the JAK2-STAT signal-transduction pathway, causes substitution of phenylalanine for valine (V617F) in the JAK2 protein and has been identified. This mutation was seen in PV by 65% to 97% and ET (30-57%) and primary myelofibrosis (35-95%). Highly sensitive methods have been used to determine the presence of the JAK2V617F mutation instead of direct sequencing. We aimed to assess JAK2 exon14 mutations by high-resolution melting (HRM) analysis, which allows variation screening in compare to other method for detecting mutation. Methods The mutation analysis included 45 individuals who were subjected for diagnosis of ph-neg MPN. Genomic DNA was isolated and different methods are performed. Results PCR RFLP, ARMS PCR and HRM method has a detection sensitivity comparable with conventional methods (Qiagen) to identify the mutations and sequencing. Conclusions For HRM analysis is cost-effective and beside that it is enzyme independence method also this method able to show amount of the mutant allele carried in samples and it's helpful for treatments follow-up and determining MRD for them.
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Affiliation(s)
- Alireza Moradabadi
- 1Student Research Committee, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Farsinejad
- 2Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Behzad Khansarinejad
- 3Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Ahamd Fatemi
- 2Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Martínez-Calle N, Pascual M, Ordoñez R, Enériz ESJ, Kulis M, Miranda E, Guruceaga E, Segura V, Larráyoz MJ, Bellosillo B, Calasanz MJ, Besses C, Rifón J, Martín-Subero JI, Agirre X, Prosper F. Epigenomic profiling of myelofibrosis reveals widespread DNA methylation changes in enhancer elements and ZFP36L1 as a potential tumor suppressor gene that is epigenetically regulated. Haematologica 2019; 104:1572-1579. [PMID: 30655376 PMCID: PMC6669145 DOI: 10.3324/haematol.2018.204917] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/15/2019] [Indexed: 12/19/2022] Open
Abstract
In this study we interrogated the DNA methylome of myelofibrosis patients using high-density DNA methylation arrays. We detected 35,215 differentially methylated CpG, corresponding to 10,253 genes, between myelofibrosis patients and healthy controls. These changes were present both in primary and secondary myelofibrosis, which showed no differences between them. Remarkably, most differentially methylated CpG were located outside gene promoter regions and showed significant association with enhancer regions. This aberrant enhancer hypermethylation was negatively correlated with the expression of 27 genes in the myelofibrosis cohort. Of these, we focused on the ZFP36L1 gene and validated its decreased expression and enhancer DNA hypermethylation in an independent cohort of patients and myeloid cell-lines. In vitro reporter assay and 5’-azacitidine treatment confirmed the functional relevance of hyper-methylation of ZFP36L1 enhancer. Furthermore, in vitro rescue of ZFP36L1 expression had an impact on cell proliferation and induced apoptosis in SET-2 cell line indicating a possible role of ZFP36L1 as a tumor suppressor gene in myelofibrosis. Collectively, we describe the DNA methylation profile of myelofibrosis, identifying extensive changes in enhancer elements and revealing ZFP36L1 as a novel candidate tumor suppressor gene.
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Affiliation(s)
- Nicolás Martínez-Calle
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Marien Pascual
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Raquel Ordoñez
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Edurne San José Enériz
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Marta Kulis
- Fundació Clínic per a la Recerca Biomèdica, Barcelona
| | - Estíbaliz Miranda
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Elisabeth Guruceaga
- Unidad de Bioinformática, Centro de Investigación Médica Aplicada, Universidad de Navarra, Pamplona
| | - Víctor Segura
- Unidad de Bioinformática, Centro de Investigación Médica Aplicada, Universidad de Navarra, Pamplona
| | | | | | - María José Calasanz
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid.,CIMA Laboratory of Diagnostics, Universidad de Navarra, Pamplona
| | - Carles Besses
- Departmento de Hematología, Hospital del Mar, Barcelona
| | - José Rifón
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid.,Departamento de Hematología, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona
| | - José I Martín-Subero
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona.,Departament de Fonaments Clinics, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Xabier Agirre
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona .,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Felipe Prosper
- Área de Hemato-Oncología, Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Pamplona .,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid.,Departamento de Hematología, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona
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Hassankrishnamurthy S, Mody MD, Kota VK. A Case of Chronic Myelogenous Leukemia Occurring in a Patient Treated for Essential Thrombocythemia. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:10-14. [PMID: 30602717 PMCID: PMC6325661 DOI: 10.12659/ajcr.911854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Patient: Female, 49 Final Diagnosis: Essential thrombocythemia with CML Symptoms: Decreased appetite • fatigue • weight loss Medication: — Clinical Procedure: — Specialty: Hematology
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Affiliation(s)
| | - Mayur D Mody
- Department of Internal Medicine, Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Vamsi K Kota
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, USA
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34
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Wanquet A, Courtier F, Guille A, Carbuccia N, Garnier S, Adélaide J, Gelsi-Boyer V, Mozziconacci MJ, Rey J, Vey N, Birnbaum D, Murati A. Mutation patterns in essential thrombocythemia, polycythemia vera and secondary myelofibrosis. Leuk Lymphoma 2019; 60:1289-1293. [PMID: 30601073 DOI: 10.1080/10428194.2018.1522437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Anne Wanquet
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France.,b Aix-Marseille Université , Marseille , France.,c Département d'Hématologie , Institut Paoli-Calmettes , Marseille , France
| | - Frédéric Courtier
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France.,b Aix-Marseille Université , Marseille , France
| | - Arnaud Guille
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France
| | - Nadine Carbuccia
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France
| | - Séverine Garnier
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France
| | - José Adélaide
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France
| | - Véronique Gelsi-Boyer
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France.,b Aix-Marseille Université , Marseille , France.,d Département de BioPathologie , Institut Paoli-Calmettes , Marseille , France
| | | | - Jérôme Rey
- c Département d'Hématologie , Institut Paoli-Calmettes , Marseille , France
| | - Norbert Vey
- b Aix-Marseille Université , Marseille , France.,c Département d'Hématologie , Institut Paoli-Calmettes , Marseille , France
| | - Daniel Birnbaum
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France.,b Aix-Marseille Université , Marseille , France
| | - Anne Murati
- a Laboratoire d'Oncologie Prédictive , Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille , Inserm U1068 CNRS UMR 7258 , Marseille , France.,b Aix-Marseille Université , Marseille , France.,d Département de BioPathologie , Institut Paoli-Calmettes , Marseille , France
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35
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Poluben L, Puligandla M, Neuberg D, Bryke CR, Hsu Y, Shumeiko O, Yuan X, Voznesensky O, Pihan G, Adam M, Fraenkel E, Rasnic R, Linial M, Klymenko S, Balk SP, Fraenkel PG. Characteristics of myeloproliferative neoplasms in patients exposed to ionizing radiation following the Chernobyl nuclear accident. Am J Hematol 2019; 94:62-73. [PMID: 30295334 DOI: 10.1002/ajh.25307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 12/20/2022]
Abstract
Myeloproliferative neoplasms (MPNs) driver mutations are usually found in JAK2, MPL, and CALR genes; however, 10%-15% of cases are triple negative (TN). A previous study showed lower rate of JAK2 V617F in primary myelofibrosis patients exposed to low doses of ionizing radiation (IR) from Chernobyl accident. To examine distinct driver mutations, we enrolled 281 Ukrainian IR-exposed and unexposed MPN patients. Genomic DNA was obtained from peripheral blood leukocytes. JAK2 V617F, MPL W515, types 1- and 2-like CALR mutations were identified by Sanger Sequencing and real time polymerase chain reaction. Chromosomal alterations were assessed by oligo-SNP microarray platform. Additional genetic variants were identified by whole exome and targeted sequencing. Statistical significance was evaluated by Fisher's exact test and Wilcoxon's rank sum test (R, version 3.4.2). IR-exposed MPN patients exhibited a different genetic profile vs unexposed: lower rate of JAK2 V617F (58.4% vs 75.4%, P = .0077), higher rate of type 1-like CALR mutation (12.2% vs 3.1%, P = .0056), higher rate of TN cases (27.8% vs 16.2%, P = .0366), higher rate of potentially pathogenic sequence variants (mean numbers: 4.8 vs 3.1, P = .0242). Furthermore, we identified several potential drivers specific to IR-exposed TN MPN patients: ATM p.S1691R with copy-neutral loss of heterozygosity at 11q; EZH2 p.D659G at 7q and SUZ12 p.V71 M at 17q with copy number loss. Thus, IR-exposed MPN patients represent a group with distinct genomic characteristics worthy of further study.
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Affiliation(s)
- Larysa Poluben
- Division of Hematology/Oncology Cancer Research Institute, Beth Israel Deaconess Medical Center Boston Massachusetts
- National Research Center for Radiation Medicine Kyiv Ukraine
| | | | - Donna Neuberg
- Dana‐Farber/Harvard Cancer Center Boston Massachusetts
| | - Christine R. Bryke
- Division of Clinical Pathology Beth Israel Deaconess Medical Center Boston Massachusetts
| | - Yahsuan Hsu
- Division of Clinical Pathology Beth Israel Deaconess Medical Center Boston Massachusetts
| | | | - Xin Yuan
- Division of Hematology/Oncology Cancer Research Institute, Beth Israel Deaconess Medical Center Boston Massachusetts
| | - Olga Voznesensky
- Division of Hematology/Oncology Cancer Research Institute, Beth Israel Deaconess Medical Center Boston Massachusetts
| | - German Pihan
- Division of Clinical Pathology Beth Israel Deaconess Medical Center Boston Massachusetts
| | - Miriam Adam
- Department of Biological Engineering Massachusetts Institute of Technology Cambridge Massachusetts
| | - Ernest Fraenkel
- Department of Biological Engineering Massachusetts Institute of Technology Cambridge Massachusetts
| | - Roni Rasnic
- School of Computer Science and Engineering & Department of Biological Chemistry Hebrew University Jerusalem Israel
| | - Michal Linial
- School of Computer Science and Engineering & Department of Biological Chemistry Hebrew University Jerusalem Israel
| | - Sergiy Klymenko
- National Research Center for Radiation Medicine Kyiv Ukraine
| | - Steven P. Balk
- Division of Hematology/Oncology Cancer Research Institute, Beth Israel Deaconess Medical Center Boston Massachusetts
| | - Paula G. Fraenkel
- Division of Hematology/Oncology Cancer Research Institute, Beth Israel Deaconess Medical Center Boston Massachusetts
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36
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Mutreja D, Saxena R, K Tilak TVSVG, Tewari V, Moorchung N, Nandi B. A 37-year-old male with extensive cerebral venous thrombosis: Clinicopathological correlation of a rare case. INDIAN J PATHOL MICR 2018; 61:219-224. [PMID: 29676361 DOI: 10.4103/ijpm.ijpm_232_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the autopsy findings and differential diagnosis of a 37-year-old immunocompetent male patient who presented primarily with extensive cerebral vein thrombosis and was found to have a rare association with JAK2V617F mutation positivity.
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Affiliation(s)
- Deepti Mutreja
- Department of Pathology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Rajeev Saxena
- Department of Medicine, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - T V S V G K Tilak
- Department of Medicine, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Vanmalini Tewari
- Department of Pathology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Nikhil Moorchung
- Department of Pathology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Bhaskar Nandi
- Department of Medicine, Command Hospital Air Force, Bengaluru, Karnataka, India
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37
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Nystrand CF, Ghanima W, Waage A, Jonassen CM. JAK2 V617F mutation can be reliably detected in serum using droplet digital PCR. Int J Lab Hematol 2017; 40:181-186. [PMID: 29150911 DOI: 10.1111/ijlh.12762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/05/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Detection of the JAK2 V617F mutation is a key step in the diagnosis of myeloproliferative neoplasms (MPN). Sensitive real-time quantitative PCR (qPCR) detection on peripheral blood (PB) is the most widely used method. The main objective of this study was to determine whether serum, the most common material available in archival biobanks, is a good liquid biopsy for detecting and quantifying the JAK2 V617F mutation using droplet digital PCR (ddPCR). METHODS Paired PB and serum samples from 66 patients with MPN were used. Serum samples were frozen at -25°C before analysis. DNA was extracted from 200 μL PB and 400 μL serum, and ddPCR analysis was performed. RESULTS Among the 47 patients with detectable mutation in their PB samples, the overall sensitivity for the detection of JAK2 mutation in serum was of 96% (45 of 47); V617F was detected in all cases where mutation load was above 1%. Our results showed very strong correlation between PB and serum (Spearman r: 0.989, P < .0001). Significantly higher allele burden was detected in serum compared to PB (Wilcoxon signed ranks test, Z = -5.672, P < .0001). CONCLUSION In our study, JAK2 V617F mutation load as low as 1% was reliably detected in serum using ddPCR.
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Affiliation(s)
- C F Nystrand
- Centre for Laboratory medicine, Østfold Hospital Trust, Kalnes, Norway
| | - W Ghanima
- Department of Oncology, Østfold Hospital Trust, Kalnes, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - A Waage
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Haematology, St. Olavs Hospital, Trondheim, Norway
| | - C M Jonassen
- Centre for Laboratory medicine, Østfold Hospital Trust, Kalnes, Norway.,Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
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38
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Peripheral circulatory disorders in essential thrombocythemia. Microvasc Res 2017; 116:15-19. [PMID: 28495449 DOI: 10.1016/j.mvr.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/05/2017] [Accepted: 05/06/2017] [Indexed: 12/27/2022]
Abstract
A significant number of patients with essential thrombocythemia (ET) complain of symptoms including distal parts of the extremities (e.g., paresthesias or Raynaud's phenomenon). The aim of the present study was to examine peripheral circulation in the upper extremities of individuals with ET. The study included 45 ET patients and 30 control subjects. All participants were subjected to thermography, photoplethysmography, impedance plethysmography, and applanation tonometry pulse wave analysis. The patients with ET differed significantly from the control subjects in terms of 3rd finger skin temperature (mean 31.04 vs. 32.45°C), skin temperature gradient (mean 1.82 vs. 0.11°C), photoplethysmographic amplitude (median 0.25 vs. 0.74%), and pulse waveform in the radial artery (more frequent occurrence of type B waveform). Pulse wave parameters correlated with the skin temperature gradient. The study findings imply the altered regulation of peripheral circulation in ET, including a decreased flow and an increased resistance.
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39
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Ji L, Qian M, Wu N, Wu J. Significance of combined detection of JAK2V617F, MPL and CALR gene mutations in patients with essential thrombocythemia. Exp Ther Med 2017; 13:947-951. [PMID: 28450924 PMCID: PMC5403657 DOI: 10.3892/etm.2017.4077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 11/03/2016] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to analyze the mutation rate of JAK2V617F, MPLW515L/K and CALR genes in adult patients with essential thrombocythemia (ET) and the accuracy of the combined detection by the receiver operating curve. Three hundred and forty-two cases with high-platelets (≥300×109/l) were consecutively selected. The patients were analyzed for routine blood examination, bone marrow biopsy and genetic testing. One hundred and fifty-four cases (45.03%) were diagnosed with ET and 188 cases of secondary thrombocythemia according to the hematopoietic and lymphoid tissue tumor classification standards of 2008. It was found that the mutant type of three genes showed three bands, whereas only one band for wild-type. The JAK2V617F and MPL mutations did not cause a change in the open reading frame and the CALR mutation resulted in its change. The mutation rate of JAK2V617F and CALR in ET group was significantly higher than that in the secondary thrombocythemia group (p<0.05). The positive mutation rate of MPL was only 4.55%. JAK2V617F-positive mutation alone was used to diagnose with ET. The area under the curve (AUC) was 0.721. The sensitivity was 72.4%, the specificity was 79.5% and the cut-off value was 0.25. When CALR-positive mutation alone was used to diagnose ET, the AUC, sensitivity, specificity and cut-off value were 0.664, 68.4, 82.4 and 0.09%, respectively. JAK2V617F combined with CALR mutation were used for diagnosis of ET. The AUC was 0.862, the sensitivity was 85.9%, the specificity was 87.8%, and the cut-off values were 0.21 and 0.07. In conclusion, the positive mutation rate of JAK2V617F and CALR in ET was higher, and the sensitivity, specificity and accuracy of the diagnosis of ET were significantly improved using the detection of JAK2V617F and CALR.
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Affiliation(s)
- Liying Ji
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Mengyao Qian
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Nana Wu
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Jianmin Wu
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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40
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Hirvonen EAM, Pitkänen E, Hemminki K, Aaltonen LA, Kilpivaara O. Whole-exome sequencing identifies novel candidate predisposition genes for familial polycythemia vera. Hum Genomics 2017; 11:6. [PMID: 28427458 PMCID: PMC5397753 DOI: 10.1186/s40246-017-0102-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/09/2017] [Indexed: 12/12/2022] Open
Abstract
Background Polycythemia vera (PV), characterized by massive production of erythrocytes, is one of the myeloproliferative neoplasms. Most patients carry a somatic gain-of-function mutation in JAK2, c.1849G > T (p.Val617Phe), leading to constitutive activation of JAK-STAT signaling pathway. Familial clustering is also observed occasionally, but high-penetrance predisposition genes to PV have remained unidentified. Results We studied the predisposition to PV by exome sequencing (three cases) in a Finnish PV family with four patients. The 12 shared variants (maximum allowed minor allele frequency <0.001 in Finnish population in ExAC database) predicted damaging in silico and absent in an additional control set of over 500 Finns were further validated by Sanger sequencing in a fourth affected family member. Three novel predisposition candidate variants were identified: c.1254C > G (p.Phe418Leu) in ZXDC, c.1931C > G (p.Pro644Arg) in ATN1, and c.701G > A (p.Arg234Gln) in LRRC3. We also observed a rare, predicted benign germline variant c.2912C > G (p.Ala971Gly) in BCORL1 in all four patients. Somatic mutations in BCORL1 have been reported in myeloid malignancies. We further screened the variants in eight PV patients in six other Finnish families, but no other carriers were found. Conclusions Exome sequencing provides a powerful tool for the identification of novel variants, and understanding the familial predisposition of diseases. This is the first report on Finnish familial PV cases, and we identified three novel candidate variants that may predispose to the disease. Electronic supplementary material The online version of this article (doi:10.1186/s40246-017-0102-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elina A M Hirvonen
- Genome-Scale Biology Research Program, Research Programs Unit and Department of Medical and Clinical Genetics, Medicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland
| | - Esa Pitkänen
- Genome-Scale Biology Research Program, Research Programs Unit and Department of Medical and Clinical Genetics, Medicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lauri A Aaltonen
- Genome-Scale Biology Research Program, Research Programs Unit and Department of Medical and Clinical Genetics, Medicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Outi Kilpivaara
- Genome-Scale Biology Research Program, Research Programs Unit and Department of Medical and Clinical Genetics, Medicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland.
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41
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Ahmed AK, Youssef A, Skeik N. Medical Management of Extensive Arterial Thromboembolism in a Patient with Essential Thrombocythemia and Warfarin Failure. Ann Vasc Surg 2017; 42:306.e5-306.e10. [PMID: 28259826 DOI: 10.1016/j.avsg.2017.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/27/2016] [Accepted: 01/02/2017] [Indexed: 12/13/2022]
Abstract
Chronic myeloproliferative disorders share a stem cell-derived clonal myeloproliferation. This group of disorders include essential thrombocythemia (ET), polycythemia vera (PV), chronic myeloid leukemia, and primary myelofibrosis (PMF), with the respective features of thrombocytosis, erythrocytosis, and bone marrow fibrosis. These disorders can be associated with genetic mutations affecting protein tyrosine kinases, resulting in different configurations of abnormal signal transduction. The Janus tyrosine kinase 2 mutation can be used as a key diagnostic tool for diagnosing MPDs, specifically, ET, PV, and PMF. Patients with ET and PV are at an increased risk for thromboembolic and hemorrhagic events. We present a unique case of ET causing extensive arterial thromboembolism, despite being on adequate antithrombotic agents including warfarin and aspirin.
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Affiliation(s)
- Aisha K Ahmed
- Minneapolis Heart Institute Research Foundation, Abbott Northwestern Hospital, Minneapolis, MN
| | - Alicia Youssef
- Minneapolis Heart Institute Research Foundation, Abbott Northwestern Hospital, Minneapolis, MN
| | - Nedaa Skeik
- Minneapolis Heart Institute Research Foundation, Abbott Northwestern Hospital, Minneapolis, MN.
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42
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Sokolova MA, Turkina AG, Melikian AL, Sudarikov AB, Treglazova SA, Shukhov OA, Gemdzhian EG, Abdullaev AО, Kovrigina AM, Misyurin AV, Pliskunova YV, Ivanova VL, Moiseeva TN. [Efficiency of interferon therapy in patients with essential thrombocythemia or polycythemia vera]. TERAPEVT ARKH 2017; 88:69-77. [PMID: 28139563 DOI: 10.17116/terarkh2016881269-77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the efficiency of interferon (IFN) therapy in patients with essential thrombocythemia (ET) and polycythemia vera (PV). SUBJECTS AND METHODS A total of 61 patients (41 with ET and 20 with PV) were examined. Prior to study enrolment, 44 (72%) patients with ET or PV received one or other therapy (aspirin was not taken into account). The mean Jak2V617F mutant allele at baseline was 23% (6-54%) in the patients with ET and 40% (11-88%) in those with PV. The median time from diagnosis to enrollment was 49 months. RESULTS The paper presents the clinical and molecular findings of long-term INF-α therapy in patients with ET or PV. The median follow-up was 52 months. Recombinant IFN-α2 showed its ability to induce complete hematologic remission (ET (76%), PV (70%)) and a complete molecular response. 22 (69%) out of 32 patients were noted to have a smaller number of cells with the Jak2V617F mutation. In the patients with PV and in those with ET, the relative reduction in the proportion of cells with the Jak2V617F mutant gene averaged 85% and 56% of the baseline values, respectively. There was a reduction in the proportion of cells expressing the Jak2V617F mutation in both the ET (from 12 to 2.2%; p=0.001) and PV (from 32.7% to 3.2%) groups (р=0.001). Ten (31%) patients achieved a deep molecular remission (≤2% Jak2V617F allele); among them, 5 patients were not found to have Jak2V617F mutation. The obtained molecular response remained in 7 of the 10 patients untreated for 11 to 86 months. The long-term treatment with IFN-α led to normalization of the morphological pattern of bone marrow in 5 of the 7 PV or ET patients. CONCLUSION Significant molecular remissions achieved by therapy with recombinant interferon-α2 confirm the appropriateness of this treatment option in in the majority of patients with ET or PV.
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Affiliation(s)
- M A Sokolova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A G Turkina
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A L Melikian
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A B Sudarikov
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - S A Treglazova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - O A Shukhov
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - E G Gemdzhian
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A О Abdullaev
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A M Kovrigina
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A V Misyurin
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - Yu V Pliskunova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - V L Ivanova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - T N Moiseeva
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
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Winton EF, Kota V. Momelotinib in myelofibrosis: JAK1/2 inhibitor with a role in treating and understanding the anemia. Future Oncol 2016; 13:395-407. [PMID: 27785927 DOI: 10.2217/fon-2016-0417] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Myelofibrosis (MF) is a chronic malignancy of the blood-forming system caused by hyperactivation of JAK2/STAT signaling pathway. Small-molecule inhibitors of JAK2 can variably ameliorate MF-related symptoms caused by chronic inflammation and hepatosplenomegaly. Anemia is a significant problem and adverse prognostic factor in over a third of MF patients and is often worsened by JAK2 inhibitors. The JAK1/2 inhibitor momelotinib unexpectedly resulted in reduction of anemia in MF patients during Phase I/II trials. Current Phase III trials will be the basis for seeking regulatory approval of momelotinib during 2017. Studies to determine how momelotinib improves anemia are underway, potentially leading to expanded momelotinib use and/or development of other targeted therapies for treating anemia in MF and related diseases.
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Affiliation(s)
- Elliott F Winton
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Vamsi Kota
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
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Liu KG, Verma A, Derman O, Kornblum N, Janakiram M, Braunschweig I, Battini R. JAK2 V617F mutation, multiple hematologic and non-hematologic processes: an association? Biomark Res 2016; 4:19. [PMID: 27777768 PMCID: PMC5069777 DOI: 10.1186/s40364-016-0073-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 10/04/2016] [Indexed: 11/20/2022] Open
Abstract
Background Population studies showed that patients with JAK2 V617F mutation had increased mortality, and increased risk of any cancer, hematologic cancer, and myeloproliferative disease. Case presentation A 68-year-old Asian male with JAK2 V617F mutation developed four different hematologic and non-hematologic neoplastic processes. In 2009, he was diagnosed with stage IA lung adenocarcinoma and also noted to have worsening leukocytosis and thrombocytosis with peak platelet count of 1,054,000/mL). Bone marrow biopsy was consistent with myeloproliferative neoplasm. His monocyte percentage increased in 2011 and met criteria for chronic myelomonocytic leukemia. In 2013, he was admitted for proximal small bowel obstruction, with biopsy confirming stage IE diffuse large B-cell lymphoma. In 2014, a bone marrow biopsy performed for worsening leukocytosis was consistent with acute myeloid leukemia with monocytic differentiation. Conclusion This is a rare case depicting the association of JAK2 V617F mutation with myeloproliferative, lymphoproliferative and solid neoplasms.
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Affiliation(s)
- Kenneth G Liu
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
| | - Amit Verma
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
| | - Olga Derman
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
| | - Noah Kornblum
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
| | - Murali Janakiram
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
| | - Ira Braunschweig
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
| | - Ramakrishna Battini
- Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467 USA
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The effects of hematopoietic stem cell transplant on splenic extramedullary hematopoiesis in patients with myeloproliferative neoplasm-associated myelofibrosis. Hematol Oncol Stem Cell Ther 2016; 9:96-104. [DOI: 10.1016/j.hemonc.2016.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/15/2016] [Accepted: 07/03/2016] [Indexed: 11/23/2022] Open
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Rapid Molecular Profiling of Myeloproliferative Neoplasms Using Targeted Exon Resequencing of 86 Genes Involved in JAK-STAT Signaling and Epigenetic Regulation. J Mol Diagn 2016; 18:707-718. [DOI: 10.1016/j.jmoldx.2016.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/22/2016] [Accepted: 05/02/2016] [Indexed: 12/14/2022] Open
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Palandri F, Auteri G, Baccarani M. New strategies in myelofibrosis: the evolving paradigm of disease pathogenesis, prognostication and treatment. Hematol Oncol 2016; 35:145-150. [DOI: 10.1002/hon.2324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/30/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Francesca Palandri
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES); Institute of Hematology “L. and A. Seràgnoli”; Bologna Italy
| | - Giuseppe Auteri
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES); Institute of Hematology “L. and A. Seràgnoli”; Bologna Italy
| | - Michele Baccarani
- Department of Hematology and Oncology “L. and A. Seràgnoli”; Sant'Orsola-Malpighi University Hospital; Via Massarenti 9 40138 Bologna Italy
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Pinilla-Ibarz J, Sweet KL, Corrales-Yepez GM, Komrokji RS. Role of tyrosine-kinase inhibitors in myeloproliferative neoplasms: comparative lessons learned. Onco Targets Ther 2016; 9:4937-57. [PMID: 27570458 PMCID: PMC4986686 DOI: 10.2147/ott.s102504] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
An important pathogenetic distinction in the classification of myeloproliferative neoplasms (MPNs) is the presence or absence of the BCR–ABL fusion gene, which encodes a unique oncogenic tyrosine kinase. The BCR–ABL fusion, caused by the formation of the Philadelphia chromosome (Ph) through translocation, constitutes the disease-initiating event in chronic myeloid leukemia. The development of successive BCR–ABL-targeted tyrosine-kinase inhibitors has led to greatly improved outcomes in patients with chronic myeloid leukemia, including high rates of complete hematologic, cytogenetic, and molecular responses. Such levels of treatment success have long been elusive for patients with Ph-negative MPNs, because of the difficulties in identifying specific driver proteins suitable as drug targets. However, in recent years an improved understanding of the complex pathobiology of classic Ph-negative MPNs, characterized by variable, overlapping multimutation profiles, has prompted the development of better and more broadly targeted (to pathway rather than protein) treatment options, particularly JAK inhibitors. In classic Ph-negative MPNs, overactivation of JAK-dependent signaling pathways is a central pathogenic mechanism, and mutually exclusive mutations in JAK2, MPL, and CALR linked to aberrant JAK activation are now recognized as key drivers of disease progression in myelofibrosis (MF). In clinical trials, the JAK1/JAK2 inhibitor ruxolitinib – the first therapy approved for MF worldwide – improved disease-related splenomegaly and symptoms independent of JAK2V617F mutational status, and prolonged survival compared with placebo or standard therapy in patients with advanced MF. In separate trials, ruxolitinib also provided comprehensive hematologic control in patients with another Ph-negative MPN – polycythemia vera. However, complete cytogenetic or molecular responses with JAK inhibitors alone are normally not observed, underscoring the need for novel combination therapies of JAK inhibitors and complementary agents that better address the complexity of the pathobiology of classic Ph-negative MPNs. Here, we discuss the role of tyrosine-kinase inhibitors in the current MPN-treatment landscape.
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Affiliation(s)
- Javier Pinilla-Ibarz
- Department of Malignant Hematology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Kendra L Sweet
- Department of Malignant Hematology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gabriela M Corrales-Yepez
- Department of Malignant Hematology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Rami S Komrokji
- Department of Malignant Hematology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Abstract
THE ROLE OF RUXOLITINIB IN THE TREATMENT OF MYELOPROLIFERATIVE NEOPLASMS: The discovery of the JAK2V617F mutation in 2005, present in 95% of polycythemia vera (PV) and in 55% of myelofibrosis (MF) patients, opened the way for a new era of targeted therapies for myeloproliferative neoplasms. Ruxolitinib was the first-in-class Janus Kinase (JAK) inhibitor approved for the management of these diseases. In PV patients, conventional treatment strategies including aspirin, phlebotomy, cytoreductive agents such as hydroxyurea and interferon, clearly provide clinical benefits. However, some patients develop resistance or intolerance to these treatments. Ruxolitinib has been approved for PV patients who are resistant to or intolerant of hydroxyurea, based on the results of the phase 3 RESPONSE study. This study showed that ruxolitinib improves hematocrit control, reduces splenomegaly, and ameliorate disease-related symptoms as compared with best available therapy. In MF patients, the only curative treatment is allogeneic stem cell transplantation, but it remains restricted to a limited group of patients with poor prognosis and who are eligible for such procedure associated with non-negligible transplant-related mortality. Other treatments are palliative and unlikely to prolong survival. Ruxolitinib has been approved in the United States for MF patients with intermediate or high-risk disease, and in Europe for disease-related splenomegaly or symptoms in adults with MF, based on phase 3 COMFORT-I and COMFORT-II studies. These studies showed that ruxolitinib was able to reduce splenomegaly, ameliorate symptoms, and improve survival. However, the journey is not finished yet since there are still important unmet needs for MF patients, including improvement in cytopenias, and significant modification of disease natural history.
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Affiliation(s)
- Juliette Soret
- Centre d'Investigations Cliniques, Hôpital Saint-Louis, APHP, Paris, France
| | - Jean-Jacques Kiladjian
- Centre d'Investigations Cliniques, Hôpital Saint-Louis, APHP, Paris, France.; Inserm UMR-S 1131, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France.
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Splenomegaly, elevated alkaline phosphatase and mutations in the SRSF2/ASXL1/RUNX1 gene panel are strong adverse prognostic markers in patients with systemic mastocytosis. Leukemia 2016; 30:2342-2350. [PMID: 27416984 DOI: 10.1038/leu.2016.190] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 06/06/2016] [Accepted: 06/10/2016] [Indexed: 01/08/2023]
Abstract
We evaluated the impact of clinical and molecular characteristics on overall survival (OS) in 108 patients with indolent (n=41) and advanced systemic mastocytosis (SM) (advSM, n=67). Organomegaly was measured by magnetic resonance imaging-based volumetry of the liver and spleen. In multivariate analysis of all patients, an increased spleen volume ⩾450 ml (hazard ratio (HR), 5.2; 95% confidence interval (CI), (2.1-13.0); P=0.003) and an elevated alkaline phosphatase (AP; HR 5.0 (1.1-22.2); P=0.02) were associated with adverse OS. The 3-year OS was 100, 77, and 39%, respectively (P<0.0001), for patients with 0 (low risk, n=37), 1 (intermediate risk, n=32) or 2 (high risk, n=39) parameters. For advSM patients with fully available clinical and molecular data (n=60), univariate analysis identified splenomegaly ⩾1200 ml, elevated AP and mutations in the SRSF2/ASXL1/RUNX1 (S/A/R) gene panel as significant prognostic markers. In multivariate analysis, mutations in S/A/R (HR 3.2 (1.1-9.6); P=0.01) and elevated AP (HR 2.6 (1.0-7.1); P=0.03) remained predictive adverse prognostic markers for OS. The 3-year OS was 76 and 38%, respectively (P=0.0003), for patients with 0-1 (intermediate risk, n=28) or 2 (high risk, n=32) parameters. We conclude that splenomegaly, elevated AP and mutations in the S/A/R gene panel are independent of the World Health Organization classification and provide the most relevant prognostic information in SM patients.
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