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Puli'uvea C, Immanuel T, Green TN, Tsai P, Shepherd PR, Kalev-Zylinska ML. Insights into the role of JAK2-I724T variant in myeloproliferative neoplasms from a unique cohort of New Zealand patients. Hematology 2024; 29:2297597. [PMID: 38197452 DOI: 10.1080/16078454.2023.2297597] [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: 08/20/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES This study aimed to compile bioinformatic and experimental information for JAK2 missense variants previously reported in myeloproliferative neoplasms (MPN) and determine if germline JAK2-I724T, recently found to be common in New Zealand Polynesians, associates with MPN. METHODS For all JAK2 variants found in the literature, gnomAD_exome allele frequencies were extracted and REVEL scores were calculated using the dbNSFP database. We investigated the prevalence of JAK2-I724T in a cohort of 111 New Zealand MPN patients using a TaqMan assay, examined its allelic co-occurrence with JAK2-V617F using Oxford Nanopore sequencing, and modelled the impact of I724T on JAK2 using I-Mutant and ChimeraX software. RESULTS Several non-V617F JAK2 variants previously reported in MPN had REVEL scores greater than 0.5, suggesting pathogenicity. JAK2-I724T (REVEL score 0.753) was more common in New Zealand Polynesian MPN patients (n = 2/27; 7.4%) than in other New Zealand patients (n = 0/84; 0%) but less common than expected for healthy Polynesians (n = 56/377; 14.9%). Patients carrying I724T (n = 2), one with polycythaemia vera and one with essential thrombocythaemia, had high-risk MPN. Both patients with JAK2-I724T were also positive for JAK2-V617F, found on the same allele as I724T, as well as separately. In silico modelling did not identify noticeable structural changes that would give JAK2-I724T a gain-of-function. CONCLUSION Several non-canonical JAK2 variants with high REVEL scores have been reported in MPN, highlighting the need to further understand their relationship with disease. The JAK2-I724T variant does not drive MPN, but additional investigations are required to exclude any potential modulatory effect on the MPN phenotype.
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Affiliation(s)
- Christopher Puli'uvea
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Hosted by the University of Auckland, Auckland, New Zealand
| | - Tracey Immanuel
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Taryn N Green
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Peter Tsai
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Hosted by the University of Auckland, Auckland, New Zealand
| | - Peter R Shepherd
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Hosted by the University of Auckland, Auckland, New Zealand
| | - Maggie L Kalev-Zylinska
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Pathology and Laboratory Medicine, Auckland City Hospital, Auckland, New Zealand
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Patchell D, Keohane C, O'Shea S, Langabeer SE. Incidence and impact of non-canonical JAK2 p.(Val617Phe) mutations in myeloproliferative neoplasm molecular diagnostics. J Clin Pathol 2024:jcp-2023-209276. [PMID: 38772616 DOI: 10.1136/jcp-2023-209276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/07/2024] [Indexed: 05/23/2024]
Affiliation(s)
| | - Clodagh Keohane
- Department of Haematology, Mercy University Hospital, Cork, Ireland
| | - Susan O'Shea
- Department of Haematology, Bon Secours Hospital Cork, Cork, Ireland
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Wang Z, Tian X, Ma J, Zhang Y, Ta W, Duan Y, Li F, Zhang H, Chen L, Yang S, Liu E, Lin Y, Yuan W, Ru K, Bai J. Clinical laboratory characteristics and gene mutation spectrum of Ph-negative MPN patients with atypical variants of JAK2, MPL, or CALR. Cancer Med 2024; 13:e7123. [PMID: 38618943 PMCID: PMC11017299 DOI: 10.1002/cam4.7123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/21/2024] [Accepted: 03/09/2024] [Indexed: 04/16/2024] Open
Abstract
OBJECTIVE To evaluate the incidence, clinical laboratory characteristics, and gene mutation spectrum of Ph-negative MPN patients with atypical variants of JAK2, MPL, or CALR. METHODS We collected a total of 359 Ph-negative MPN patients with classical mutations in driver genes JAK2, MPL, or CALR, and divided them into two groups based on whether they had additional atypical variants of driver genes JAK2, MPL, or CALR: 304 patients without atypical variants of driver genes and 55 patients with atypical variants of driver genes. We analyzed the relevant characteristics of these patients. RESULTS This study included 359 patients with Ph-negative MPNs with JAK2, MPL, or CALR classical mutations and found that 55 (15%) patients had atypical variants of JAK2, MPL, or CALR. Among them, 28 cases (51%) were male, and 27 (49%) were female, with a median age of 64 years (range, 21-83). The age of ET patients with atypical variants was higher than that of ET patients without atypical variants [70 (28-80) vs. 61 (19-82), p = 0.03]. The incidence of classical MPL mutations in ET patients with atypical variants was higher than in ET patients without atypical variants [13.3% (2/15) vs. 0% (0/95), p = 0.02]. The number of gene mutations in patients with atypical variants of driver genes PV, ET, and Overt-PMF is more than in patients without atypical variants of PV, ET, and Overt-PMF [PV: 3 (2-6) vs. 2 (1-7), p < 0.001; ET: 4 (2-8) vs. 2 (1-7), p < 0.05; Overt-PMF: 5 (2-9) vs. 3 (1-8), p < 0.001]. The incidence of SH2B3 and ASXL1 mutations were higher in MPN patients with atypical variants than in those without atypical variants (SH2B3: 16% vs. 6%, p < 0.01; ASXL1: 24% vs. 13%, p < 0.05). CONCLUSION These data indicate that classical mutations of JAK2, MPL, and CALR may not be completely mutually exclusive with atypical variants of JAK2, MPL, and CALR. In this study, 30 different atypical variants of JAK2, MPL, and CALR were identified, JAK2 G127D being the most common (42%, 23/55). Interestingly, JAK2 G127D only co-occurred with JAK2V617F mutation. The incidence of atypical variants of JAK2 in Ph-negative MPNs was much higher than that of the atypical variants of MPL and CALR. The significance of these atypical variants will be further studied in the future.
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Affiliation(s)
- Zhanlong Wang
- Department of HematologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Xin Tian
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Jinyu Ma
- Department of HematologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
| | - Yuhui Zhang
- Department of HematologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
| | - Wenru Ta
- Department of HematologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Yifan Duan
- Department of HematologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
| | - Fengli Li
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Hong Zhang
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Long Chen
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Shaobin Yang
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Enbin Liu
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Yani Lin
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
| | - Weiping Yuan
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeTianjinChina
| | - Kun Ru
- Sino‐US Diagnostics LabTianjin Enterprise Key Laboratory of AI‐aided Hematopathology DiagnosisTianjinChina
- Department of Pathology and Lab MedicineShandong Cancer HospitalJinanChina
| | - Jie Bai
- Department of HematologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
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Wu S, Li Y, Huang R, Li T, Yu Y, Luo P, Zuo X, He L. Detection and quantification of JAK2V617F copy number by droplet digital PCR versus real-time PCR. Ann Hematol 2024; 103:421-426. [PMID: 37968422 DOI: 10.1007/s00277-023-05544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023]
Abstract
Myeloproliferative neoplasm (MPN) usually has an adverse prognosis, progressing to acute leukemia or splanchnic vein thromboses (SVTs). Therefore, early diagnosis and intervention are significantly important. Clinically, the burden of JAK2V617F is a vital diagnostic basis, which can be detected during the early stage of MPN. Thus, an accurate and rapid detective technique is urgently required. In recent years, real-time quantitative PCR (qPCR) has primarily been applied to detect the copies of JAK2V617F, whereas droplet digital PCR (ddPCR), a novel and promising detective tool, can conduct precise and repeatable quantification of nucleic acid copies without relying on the standard curve. In our study, both qPCR and ddPCR are used to evaluate the mutation burden of JAK2V617F in a series of gradient diluted standards and clinical JAK2V617F-positive MPN patients' bone marrow samples collected, while using next-generation sequencing technology (NGS) as a contrast. With the help of statistical methods, our study concluded that ddPCR had a better performance in accuracy, sensitivity, and stability, especially in a low burden. Regarding the accuracy, ddPCR showed a better linearity (Pearson R2 = 0.9926; P < 0.0001) than qPCR (Pearson R2 = 0.9772; P < 0.0001). What is more, ddPCR showed lower intra-assay and inter-assay CVs and the limit of detection (LOD) for the series of diluted standards than qPCR, demonstrating better stability and lower LOD. In a nutshell, ddPCR is a more promising technique for the detection and quantification of JAK2V617F.
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Affiliation(s)
- Sanyun Wu
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China.
| | - Yixuan Li
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
| | - Ruiying Huang
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
| | - Ting Li
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
| | - Yalan Yu
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
| | - Ping Luo
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
| | - Xuelan Zuo
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
| | - Li He
- Department of Hematology, Zhongnan Hospital of Wuhan University, Donghu Road, No. 169, Wuhan, China
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Henze L, Grunwald L, Felser S, Witte M, Grosse-Thie C, Roolf C, Murua Escobar H, Junghanss C. Abdominal venous thromboses: detection of the JAK2 p.V617F mutation by next-generation ultradeep sequencing-A prevalence study of patients in Mecklenburg-West Pomerania (2017-2021). Front Med (Lausanne) 2024; 10:1344769. [PMID: 38274463 PMCID: PMC10808308 DOI: 10.3389/fmed.2023.1344769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Background Abdominal venous thromboses are rare thrombotic events with heterogeneous etiologies. They are related to myeloproliferative neoplasms (MPNs) in some patients and can occur as first signs of the disease. MPNs are characterized by mutations in the genes of Janus kinase 2 (JAK2), myeloproliferative leukemia virus oncogene (MPL), and calreticulin (CALR). Methods Within the prospective trial "Prevalence of JAK2 mutations in patients with abdominal venous thromboses" (JAK2 MV study; German Clinical Trials Register: DRKS00026943), the peripheral blood of patients with abdominal venous thromboses in Mecklenburg-West Pomerania, a federal state located in north-east Germany, was analyzed by next-generation ultradeep sequencing for MPN-associated mutations. Clinical characteristics and blood cell counts were also of interest. The primary endpoint was the detection of the mutation JAK2 p.V617F. Secondary endpoints were the detection of other acquired variants of JAK2, as well as MPL and CALR. Results A total of 68 patients with abdominal venous thromboses were included from February 2017 to January 2021, with splanchnic veins affected in 65 patients. The mutation JAK2 p.V617F was present in 13 patients (19%), with four patients showing low variant allele frequencies (VAF 0.1% to 1.9%). The time interval from the thrombotic event to analysis was longer for patients with the mutation. The mutation MPL p.W515R was detected in three cases, all of them with low VAF. One patient among them had a concurrent mutation of JAK2 p.V617F. The mutations CALR type I or type II were not found. Discussion By analyzing peripheral blood for the mutation JAK2 p.V617F, an important cause of these rare thrombotic events can be identified. The development of a diagnostic workup with next-generation ultradeep sequencing for the analysis of the JAK2 p.V617F mutation and further mutations has the potential to better understand the etiology of abdominal venous thromboses in individual patients in regional clinical care, as abdominal venous thromboses are diagnosed by various medical disciplines.
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Affiliation(s)
- Larissa Henze
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Luise Grunwald
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Sabine Felser
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Maria Witte
- Department of General, Visceral, Thoracic, Vascular, and Transplant Surgery, Rostock University Medical Center, Rostock, Germany
| | - Christina Grosse-Thie
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Catrin Roolf
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Hugo Murua Escobar
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christian Junghanss
- Department of Medicine, Clinic III—Hematology, Oncology, and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
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Ligia S, Scalzulli E, Carmosino I, Palumbo G, Molinari MC, Poggiali R, Costa A, Bisegna ML, Martelli M, Breccia M. Ropeginterferon alfa-2b treatment in a young patient with multi-refractory polycythemia vera and double JAK2 gene mutation: a case report. Front Oncol 2024; 13:1338417. [PMID: 38264737 PMCID: PMC10803620 DOI: 10.3389/fonc.2023.1338417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024] Open
Abstract
This case report presents a 3-year-old female patient initially diagnosed with polycythemia vera (PV) in 2001. The patient exhibited elevated red blood cell (RBC) counts, high hemoglobin (Hb) levels, hyperleukocytosis, and moderate thrombocytosis, with sporadic abdominal pain and significant splenomegaly. Despite various treatments, including phlebotomies, hydroxyurea, and alpha-interferon, the patient struggled to maintain optimal hematocrit levels and experienced persistent symptoms. Subsequent genomic analysis revealed a rare JAK2 G301R mutation alongside the canonical JAK2 V617F mutation, potentially contributing to disease severity. In 2023, the patient started Ropeginterferon alfa-2b, leading to improved hematological parameters and symptom relief. The case underscores the challenges in managing PV, particularly in young patients, and highlights the potential clinical significance of additional JAK2 mutations/variants and the potential benefits of Ropeginterferon alfa-2b in achieving better disease control.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Massimo Breccia
- Hematology, Department of Translational and Precision Medicine, Azienda Policlinico Umberto I - Sapienza University, Rome, Italy
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Pescia C, Lopez G, Cattaneo D, Bucelli C, Gianelli U, Iurlo A. The molecular landscape of myeloproliferative neoplasms associated with splanchnic vein thrombosis: Current perspective. Leuk Res 2024; 136:107420. [PMID: 38016412 DOI: 10.1016/j.leukres.2023.107420] [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: 06/26/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/30/2023]
Abstract
BCR::ABL1-negative myeloproliferative neoplasms (MPNs) are classically represented by polycythemia vera, essential thrombocythemia, and primary myelofibrosis. BCR::ABL1-negative MPNs are significantly associated with morbidity and mortality related to an increased risk of thrombo-hemorrhagic events. They show a consistent association with splanchnic vein thrombosis (SVT), either represented by the portal, mesenteric or splenic vein thrombosis, or Budd-Chiari Syndrome. SVT is also a frequent presenting manifestation of MPN. MPNs associated with SVT show a predilection for younger women, high association with JAK2V617F mutation, low JAK2V617F variant allele frequency (generally <10 %), and low rates of CALR, MPL, or JAK2 exon 12 mutations. Next-Generation Sequencing techniques have contributed to deepening our knowledge of the molecular landscape of such cases, with potential diagnostic and prognostic implications. In this narrative review, we analyze the current perspective on the molecular background of MPN associated with SVT, pointing as well future directions in this field.
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Affiliation(s)
- Carlo Pescia
- Unit of Anatomic Pathology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Gianluca Lopez
- Unit of Anatomic Pathology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Cristina Bucelli
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Umberto Gianelli
- Department of Health Sciences, University of Milan, Milan, Italy; Unit of Anatomic Pathology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Torres DG, Barbosa Alves EV, Araújo de Sousa M, Laranjeira WH, Paes J, Alves E, Canté D, Costa AG, Malheiro A, Abreu R, Nascimento L, Fraiji NA, Silva GA, Mourão LPDS, Tarragô AM. Molecular landscape of the JAK2 gene in chronic myeloproliferative neoplasm patients from the state of Amazonas, Brazil. Biomed Rep 2023; 19:98. [PMID: 37954635 PMCID: PMC10633817 DOI: 10.3892/br.2023.1680] [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: 07/06/2023] [Accepted: 09/22/2023] [Indexed: 11/14/2023] Open
Abstract
JAK2V617F (dbSNP: rs77375493) is the most frequent and most-studied variant in BCR::ABL1 negative myeloproliferative neoplasms and in the JAK2 gene. The present study aimed to molecularly characterize variants in the complete coding region of the JAK2 gene in patients with BCR::ABL1 negative chronic myeloproliferative neoplasms. The study included 97 patients with BCR::ABL1 negative myeloproliferative neoplasms, including polycythemia vera (n=38), essential thrombocythemia (n=55), and myelofibrosis (n=04). Molecular evaluation was performed using conventional PCR and Sanger sequencing to detect variants in the complete coding region of the JAK2 gene. The presence of missense variants in the JAK2 gene including rs907414891, rs2230723, rs77375493 (JAK2V617F), and rs41316003 were identified. The coexistence of variants was detected in polycythemia vera and essential thrombocythemia. Thus, individuals with high JAK2V617F variant allele frequency (≥50% VAF) presented more thrombo-hemorrhagic events and manifestations of splenomegaly compared with those with low JAK2V617F variant allele frequency (<50% VAF). In conclusion, individuals with BCR::ABL1 negative neoplasms can display >1 variant in the JAK2 gene, especially rs2230722, rs2230724, and rs77375493 variants, and those with high JAK2V617F VAF show alterations in the clinical-laboratory profile compared with those with low JAK2V617F VAF.
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Affiliation(s)
- Dania G. Torres
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
- Molecular Biology Center, University of Central America, Managua 14003, Nicaragua
| | - Emanuela V. Barbosa Alves
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Miliane Araújo de Sousa
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Wanessa H. Laranjeira
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Jhemerson Paes
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Erycka Alves
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Deborah Canté
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Allyson G. Costa
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
- Post-graduate Program in Basic and Applied Immunology, Federal University of Amazonas, Manaus, Amazonas State 69067-005, Brazil
- Manaus School of Nursing, Federal University of Amazonas, Manaus, Amazonas State 69057-070, Brazil
- Amazon Genomic Health Surveillance Network Coordination, Manaus, Amazonas State 69040-010, Brazil
| | - Adriana Malheiro
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
- Post-graduate Program in Basic and Applied Immunology, Federal University of Amazonas, Manaus, Amazonas State 69067-005, Brazil
- Amazon Genomic Health Surveillance Network Coordination, Manaus, Amazonas State 69040-010, Brazil
| | - Rosângela Abreu
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Leny Nascimento
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - Nelson A. Fraiji
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
| | - George A.V. Silva
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Amazon Genomic Health Surveillance Network Coordination, Manaus, Amazonas State 69040-010, Brazil
- Leonidas and Maria Deane Institute, Oswaldo Cruz Foundation, Manaus, Amazonas State 69027-070, Brazil
| | - Lucivana P. de Souza Mourão
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Superior School of Health Sciences, Amazonas State University, Manaus, Amazonas State 69065-001, Brazil
| | - Andréa M. Tarragô
- Post-graduate Program in Sciences Applied to Hematology, University of Amazonas State, Manaus, Amazonas State 69850-001, Brazil
- Board of Teaching and Research, Hospital Foundation for Hematology and Hemotherapy of Amazonas, Manaus, Amazonas State 69050-001, Brazil
- Post-graduate Program in Basic and Applied Immunology, Federal University of Amazonas, Manaus, Amazonas State 69067-005, Brazil
- Amazon Genomic Health Surveillance Network Coordination, Manaus, Amazonas State 69040-010, Brazil
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Langabeer SE. Dual Drivers in the Myeloproliferative Neoplasms: An Underestimation? Technol Cancer Res Treat 2023; 22:15330338231179561. [PMID: 37312522 DOI: 10.1177/15330338231179561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Stephen E Langabeer
- Cancer Molecular Diagnostics, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
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Thiele J, Kvasnicka HM, Orazi A, Gianelli U, Gangat N, Vannucchi AM, Barbui T, Arber DA, Tefferi A. The international consensus classification of myeloid neoplasms and acute Leukemias: myeloproliferative neoplasms. Am J Hematol 2023; 98:166-179. [PMID: 36200127 DOI: 10.1002/ajh.26751] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 02/04/2023]
Abstract
A group of international experts, including hematopathologists, oncologists, and geneticists were recently summoned (September 2021, Chicago, IL, USA) to update the 2016/17 World Health Organization classification system for hematopoietic tumors. After careful deliberation, the group introduced the new International Consensus Classification (ICC) for Myeloid Neoplasms and Acute Leukemias. This current in-depth review focuses on the ICC-2022 category of JAK2 mutation-prevalent myeloproliferative neoplasms (MPNs): essential thrombocythemia, polycythemia vera, primary myelofibrosis, and MPN, unclassifiable. The ICC MPN subcommittee chose to preserve the primary role of bone marrow morphology in disease classification and diagnostics, while also acknowledging the complementary role of genetic markers for establishing clonality, facilitating MPN subtype designation, and disease prognostication.
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Affiliation(s)
- Jürgen Thiele
- Institute of Pathology, University of Cologne, Cologne, Germany
| | | | - Attilio Orazi
- Department of Pathology, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | - Umberto Gianelli
- Department of Health Sciences and S.C. Anatomia Patologica, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Naseema Gangat
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Alessandro M Vannucchi
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tiziano Barbui
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Daniel A Arber
- Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Ayalew Tefferi
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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11
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Clonogenic assays improve determination of variant allele frequency of driver mutations in myeloproliferative neoplasms. Ann Hematol 2022; 101:2655-2663. [PMID: 36269400 DOI: 10.1007/s00277-022-05000-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/01/2022] [Indexed: 11/27/2022]
Abstract
Molecular diagnostics moves more into focus as technology advances. In patients with myeloproliferative neoplasms (MPN), identification and monitoring of the driver mutations have become an integral part of diagnosis and monitoring of the disease. In some patients, none of the known driver mutations (JAK2V617F, CALR, MPL) is found, and they are termed "triple negative" (TN). Also, whole-blood variant allele frequency (VAF) of driver mutations may not adequately reflect the VAF in the stem cells driving the disease. We reasoned that colony forming unit (CFU) assay-derived clonogenic cells may be better suited than next-generation sequencing (NGS) of whole blood to detect driver mutations in TN patients and to provide a VAF of disease-driving cells. We have included 59 patients carrying the most common driver mutations in the establishment or our model. Interestingly, cloning efficiency correlated with whole blood VAF (p = 0.0048), suggesting that the number of disease-driving cells correlated with VAF. Furthermore, the clonogenic VAF correlated significantly with the NGS VAF (p < 0.0001). This correlation was lost in patients with an NGS VAF <15%. Further analysis showed that in patients with a VAF <15% by NGS, clonogenic VAF was higher than NGS VAF (p = 0.003), suggesting an enrichment of low numbers of disease-driving cells in CFU assays. However, our approach did not enhance the identification of driver mutations in 5 TN patients. A significant correlation of lactate dehydrogenase (LDH) serum levels with both CFU- and NGS-derived VAF was found. Our results demonstrate that enrichment for clonogenic cells can improve the detection of MPN driver mutations in patients with low VAF and that LDH levels correlate with VAF.
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12
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Maslah N, Ravdan O, Drevon L, Verger E, Belkhodja C, Chomienne C, Cassinat B, Kiladjian JJ, Giraudier S, Schlageter MH. Revisiting Diagnostic performances of serum erythropoïetin level and JAK2 mutation for polycythemias: analysis of a cohort of 1090 patients with red cell mass measurement. Br J Haematol 2021; 196:676-680. [PMID: 34562020 DOI: 10.1111/bjh.17848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/19/2021] [Accepted: 09/09/2021] [Indexed: 02/03/2023]
Abstract
We assessed the diagnostic performances of erythropoietin and JAK2 mutations in 1,090 patients with suspected polycythemia who were referred for red cell mass (RCM) measurement. In patients with a high haematocrit and/or haemoglobin level, a low erythropoietin level (<=3·3 mUI/ml) and JAK2 mutation showed comparable positive predictive value (PPV) for true polycythemia (RCM>=125%), 92·1% and 90% respectively. A very-low erythropoietin level (<=1·99 mUI/ml) had a PPV of 100% for polycythemia vera (PV) diagnosis. We confirmed the correlations between RCM, erythropoietin and JAK2 variant allelic frequency in PV patients. This study prompts the need to revisit the role of EPO in PV diagnostic criteria.
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Affiliation(s)
- Nabih Maslah
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France
| | | | - Louis Drevon
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France
| | - Emmanuelle Verger
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France
| | - Célia Belkhodja
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France
| | - Christine Chomienne
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France
| | - Bruno Cassinat
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France
| | - Jean-Jacques Kiladjian
- France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France.,APHP, Centre d'Investigations Cliniques, Hôpital Saint-Louis, Paris, France
| | - Stéphane Giraudier
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France
| | - Marie-Hélène Schlageter
- APHP, Biologie Cellulaire, Hôpital Saint-Louis, Paris, France.,France Intergroupe Syndromes Myéloprolifératifs (FIM), Paris, France.,Université de Paris, U1131 INSERM, IRSL, Paris, France
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13
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Di Francia R, Crisci S, Muto T, Giancola C, Petriccone L, Catapano O, Cummarro A, Pinto A, Frigeri F. Optimization of a Low-Cost, Sensitive PNA Clamping PCR Method for JAK2 V617F Variant Detection. J Appl Lab Med 2021; 5:643-655. [PMID: 32407536 DOI: 10.1093/jalm/jfaa041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/14/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND The JAK2 V617F variant is diagnostic for myeloproliferative neoplasms, a group of clonal disorders of hematopoietic stem and progenitor cells. Although several approaches have been developed to detect the variant, a gold standard diagnostic method has not yet been defined. We describe a simple, fast, and cost-effective PCR-based approach that enhances test specificity and sensitivity by blocking the amplification of the large excess of wild-type DNA. METHODS The method involves using an oligo peptide nucleic acid (PNA) perfectly matching its corresponding DNA sequence. The PCR protocol was optimized by collecting a detailed thermodynamic data set on PNA-DNA wild-type duplexes by circular dichroism melting experiments. The specificity and sensitivity of PNA clamping PCR were assessed by genotyping 50 patients with myeloproliferative neoplasm who carried the JAK2 V617F variant and 50 healthy donors. RESULTS The optimized protocol enabled selective amplification of the variant alleles, achieving maximum sensitivity (100%) and specificity (100%). Analytical sensitivity was 0.05% of variant alleles as assessed by serial dilutions of DNA from the HEL cell line (which carries the JAK2 V617F variant) mixed to wild-type DNA from healthy donors. The JAK2 V617F variant test performed according to this method has better diagnostic performance than its 2 main PCR-based competitors, at much lower cost. CONCLUSIONS High sensitivity and specificity and cost-effectiveness make PNA clamping PCR a useful testing platform for the detection of minor allele variants in small-scale diagnostic laboratories. It promises to improve patient care while enabling significant healthcare savings.
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Affiliation(s)
- Raffaele Di Francia
- Italian Association of Pharmacogenomics and Molecular Diagnostics, Ancona, Italy
| | - Stefania Crisci
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Napoli, Italy
| | - Tommaso Muto
- Hematology and Cellular Immunology (Clinical Biochemistry) A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Concetta Giancola
- Department of Pharmacy, University of Naples Federico II, Napoli, Italy
| | - Luigi Petriccone
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Oriana Catapano
- Italian Association of Pharmacogenomics and Molecular Diagnostics, Ancona, Italy
| | - Annunziata Cummarro
- Pharmacy Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Napoli, Italy
| | - Antonio Pinto
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Napoli, Italy
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14
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Stuckey R, Gómez-Casares MT. Recent Advances in the Use of Molecular Analyses to Inform the Diagnosis and Prognosis of Patients with Polycythaemia Vera. Int J Mol Sci 2021; 22:5042. [PMID: 34068690 PMCID: PMC8126083 DOI: 10.3390/ijms22095042] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 01/07/2023] Open
Abstract
Genetic studies in the past decade have improved our understanding of the molecular basis of the BCR-ABL1-negative myeloproliferative neoplasm (MPN) polycythaemia vera (PV). Such breakthroughs include the discovery of the JAK2V617F driver mutation in approximately 95% of patients with PV, as well as some very rare cases of familial hereditary MPN caused by inherited germline mutations. Patients with PV often progress to fibrosis or acute myeloid leukaemia, both associated with very poor clinical outcome. Moreover, thrombosis and major bleeding are the principal causes of morbidity and mortality. As a result of increasingly available and economical next-generation sequencing technologies, mutational studies have revealed the prognostic relevance of a few somatic mutations in terms of thrombotic risk and risk of transformation, helping to improve the risk stratification of patients with PV. Finally, knowledge of the molecular basis of PV has helped identify targets for directed therapy. The constitutive activation of the tyrosine kinase JAK2 is targeted by ruxolitinib, a JAK1/JAK2 tyrosine kinase inhibitor for PV patients who are resistant or intolerant to cytoreductive treatment with hydroxyurea. Other molecular mechanisms have also been revealed, and numerous agents are in various stages of development. Here, we will provide an update of the recent published literature on how molecular testing can improve the diagnosis and prognosis of patients with PV and present recent advances that may have prognostic value in the near future.
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Affiliation(s)
- Ruth Stuckey
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas, Spain
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15
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Kiladjian JJ, Debureaux PE, Plessier A, Soret-Dulphy J, Valla D, Cassinat B, Rautou PE. Benefits of molecular profiling with next-generation sequencing for the diagnosis and prognosis of myeloproliferative neoplasms in splanchnic vein thrombosis. J Hepatol 2021; 74:251-252. [PMID: 32988658 DOI: 10.1016/j.jhep.2020.07.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/04/2022]
Affiliation(s)
- Jean-Jacques Kiladjian
- Centre d'Investigations Cliniques (Inserm CIC1427), Hôpital Saint-Louis, Université de Paris, Paris, France; Université de Paris, U1131 Inserm, IRSL, F-75010 Paris, France; Laboratoire d'Excellence GR-Ex, Paris, France.
| | - Pierre-Edouard Debureaux
- Centre d'Investigations Cliniques (Inserm CIC1427), Hôpital Saint-Louis, Université de Paris, Paris, France
| | - Aurélie Plessier
- Hôpital Beaujon, AP-HP, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Inserm U1149, Centre de Recherche sur l'Inflammation (CRI), Paris, Université de Paris, ERN Rare Liver Diseases, Clichy, France
| | - Juliette Soret-Dulphy
- Centre d'Investigations Cliniques (Inserm CIC1427), Hôpital Saint-Louis, Université de Paris, Paris, France
| | - Dominique Valla
- Hôpital Beaujon, AP-HP, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Inserm U1149, Centre de Recherche sur l'Inflammation (CRI), Paris, Université de Paris, ERN Rare Liver Diseases, Clichy, France
| | - Bruno Cassinat
- Université de Paris, U1131 Inserm, IRSL, F-75010 Paris, France; Laboratoire d'Excellence GR-Ex, Paris, France; AP-HP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France
| | - Pierre-Emmanuel Rautou
- Hôpital Beaujon, AP-HP, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Inserm U1149, Centre de Recherche sur l'Inflammation (CRI), Paris, Université de Paris, ERN Rare Liver Diseases, Clichy, France
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16
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Iurlo A, Cattaneo D, Bucelli C, Baldini L. New Perspectives on Polycythemia Vera: From Diagnosis to Therapy. Int J Mol Sci 2020; 21:ijms21165805. [PMID: 32823537 PMCID: PMC7461104 DOI: 10.3390/ijms21165805] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022] Open
Abstract
Polycythemia vera (PV) is mainly characterized by elevated blood cell counts, thrombotic as well as hemorrhagic predisposition, a variety of symptoms, and cumulative risks of fibrotic progression and/or leukemic evolution over time. Major changes to its diagnostic criteria were made in the 2016 revision of the World Health Organization (WHO) classification, with both hemoglobin and hematocrit diagnostic thresholds lowered to 16.5 g/dL and 49% for men, and 16 g/dL and 48% for women, respectively. The main reason leading to these changes was represented by the recognition of a new entity, namely the so-called “masked PV”, as individuals suffering from this condition have a worse outcome, possibly owing to missed or delayed diagnoses and lower intensity of treatment. Thrombotic risk stratification is of crucial importance to evaluate patients’ prognosis at diagnosis. Currently, patients are stratified into a low-risk group, in the case of younger age (<60 years) and no previous thromboses, and a high-risk group, in the case of patients older than 60 years and/or with a previous thrombotic complication. Furthermore, even though they have not yet been formally included in a scoring system, generic cardiovascular risk factors, particularly hypertension, smoking, and leukocytosis, contribute to the thrombotic overall risk. In the absence of agents proven to modify its natural history and prevent progression, PV management has primarily been focused on minimizing the thrombotic risk, representing the main cause of morbidity and mortality. When cytoreduction is necessary, conventional therapies include hydroxyurea as a first-line treatment and ruxolitinib and interferon in resistant/intolerant cases. Each therapy, however, is burdened by specific drawbacks, underlying the need for improved strategies. Currently, the therapeutic landscape for PV is still expanding, and includes several molecules that are under investigation, like long-acting pegylated interferon alpha-2b, histone deacetylase inhibitors, and murine double minute 2 (MDM2) inhibitors.
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Affiliation(s)
- Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.B.); (L.B.)
- Correspondence: ; Tel.: +39-02-5503-3463; Fax: +39-02-5503-4105
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.B.); (L.B.)
| | - Cristina Bucelli
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.B.); (L.B.)
| | - Luca Baldini
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.B.); (L.B.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
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17
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Palumbo GA, Stella S, Pennisi MS, Pirosa C, Fermo E, Fabris S, Cattaneo D, Iurlo A. The Role of New Technologies in Myeloproliferative Neoplasms. Front Oncol 2019; 9:321. [PMID: 31106152 PMCID: PMC6498877 DOI: 10.3389/fonc.2019.00321] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
The hallmark of BCR-ABL1-negative myeloproliferative neoplasms (MPNs) is the presence of a driver mutation in JAK2, CALR, or MPL gene. These genetic alterations represent a key feature, useful for diagnostic, prognostic and therapeutical approaches. Molecular biology tests are now widely available with different specificity and sensitivity. Recently, the allele burden quantification of driver mutations has become a useful tool, both for prognostication and efficacy evaluation of therapies. Moreover, other sub-clonal mutations have been reported in MPN patients, which are associated with poorer prognosis. ASXL1 mutation appears to be the worst amongst them. Both driver and sub-clonal mutations are now taken into consideration in new prognostic scoring systems and may be better investigated using next generation sequence (NGS) technology. In this review we summarize the value of NGS and its contribution in providing a comprehensive picture of mutational landscape to guide treatment decisions. Finally, discussing the role that NGS has in defining the potential risk of disease development, we forecast NGS as the standard molecular biology technique for evaluating these patients.
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Affiliation(s)
- Giuseppe A Palumbo
- Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Stefania Stella
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Maria Stella Pennisi
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Cristina Pirosa
- Postgraduate School of Hematology, University of Catania, Catania, Italy
| | - Elisa Fermo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sonia Fabris
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Iurlo
- Hematology Division, Myeloproliferative Syndromes Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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