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Cai P, Liu S, Duan L, Huo L, Wu D, Chen S, Yang R, Yang X. Sustained Response to Ruxolitinib of Eosinophilia-Associated Myeloproliferative Neoplasm with Translocation t(8;9)(p21;p24). Acta Haematol 2023; 146:397-400. [PMID: 37562364 DOI: 10.1159/000510281] [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: 01/19/2020] [Accepted: 07/17/2020] [Indexed: 08/12/2023]
Abstract
The translocation t(8;9) produces the fusion gene PCM1-JAK2, resulting in the continuous activation of the JAK2 tyrosine kinase. Myelodysplastic/myeloproliferative neoplasms are the most common disease with t(8;9)/PCM1-JAK2. Individuals with this abnormality have similar features, and JAK2 kinase inhibitor (ruxolitinib) is an effective treatment of the condition. The long-term remission results of ruxolitinib are varied. It is important to determine the response to ruxolitinib. Here, we describe a patient who has been diagnosed with eosinophilia-associated myeloproliferative neoplasm with t(8;9)(p21;p24). This patient has achieved sustained response for >1 year since the administration of ruxolitinib.
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Affiliation(s)
- Ping Cai
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Suhui Liu
- Department of Hematology, NanYang Central Hospital, Henan, China
| | - Lijuan Duan
- Department of Hematology, NanYang Central Hospital, Henan, China
| | - Li Huo
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Depei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Suzhou, China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Suning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Suzhou, China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Ruyu Yang
- Department of Hematology, NanYang Central Hospital, Henan, China
| | - Xiaofei Yang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Suzhou, China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
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2
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Kaplan HG, Jin R, Bifulco CB, Scanlan JM, Corwin DR. OUP accepted manuscript. Oncologist 2022; 27:e661-e670. [PMID: 35472244 PMCID: PMC9355817 DOI: 10.1093/oncolo/oyac072] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background This review summarizes the case studies of PCM1-JAK2 fusion tyrosine kinase gene-related neoplasia. Recommended treatment includes JAK2 inhibitors and hematologic stem cell transplantation (HSCT), although the small number of patients has limited study of their efficacy. Herein, we present all available cases in the current searchable literature with their demographics, diagnoses, treatments, and outcomes. Methods PubMed, ScienceDirect, Publons, the Cochrane Library, and Google were searched with the following terms: PCM1-JAK2, ruxolitinib and myeloid/lymphoid. Results Sixty-six patients (mean age = 50, 77% male) had an initial diagnosis of myeloproliferative neoplasm (MPN) in 40, acute leukemia in 21 and T-cell cutaneous lymphoma in 5. Thirty-five patients (53%) had completed 5-year follow-up. The 5-year survival for the MPN, acute myelogenous leukemia (AML), acute lymphocytic leukemia, and lymphoma groups are 62.7, 14.9%, 40.0%, and 100%, respectively. Too few patients have been treated with ruxolitinib to draw conclusions regarding its effect on survival while the 5-year survival for MPN patients with or without HSCT was 80.2% (40.3%-94.8%) versus 51.5% (22.3%-74.6%), respectively. The T-cell cutaneous lymphoma patients have all survived at least 7 years. Conclusion This rare condition may be increasingly detected with wider use of genomics. Ruxolitinib can yield hematologic and molecular remissions. However, HSCT is, at this time, the only potentially curative treatment. Useful prognostic markers are needed to determine appropriate timing for HSCT in patients with MPN. Patients presenting with acute leukemia have a poor prognosis.
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Affiliation(s)
- Henry G Kaplan
- Corresponding author: Henry G. Kaplan, MD, Swedish Cancer Institute, 1221 Madison St, Suite 920, Seattle, Washington 98104, USA. Tel: +1 206 310 4259.
| | - Ruyun Jin
- Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Providence Research Network, Portland, OR, USA
| | | | - James M Scanlan
- Swedish Center for Research and Innovation, Seattle, WA, USA
| | - David R Corwin
- CellNetix, Seattle, WA, USA
- Swedish Medical Center, Seattle, WA, USA
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3
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Sun Y, Cai Y, Chen J, Cen J, Zhu M, Pan J, Wu D, Sun A, Chen S. Diagnosis and Treatment of Myeloproliferative Neoplasms With PCM1-JAK2 Rearrangement: Case Report and Literature Review. Front Oncol 2021; 11:753842. [PMID: 34707996 PMCID: PMC8542851 DOI: 10.3389/fonc.2021.753842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/22/2021] [Indexed: 02/03/2023] Open
Abstract
Myeloproliferative neoplasm (MPN) with PCM1-JAK2 rearrangement is a rare disease with poor prognosis and lacks uniform treatment guidelines. Several studies confirmed the efficacy of ruxolitinib in hematological malignancies with PCM1-JAK2 fusion, but the efficacy is variable. Here, we report two patients diagnosed with MPN with PCM1-JAK2 fusion who were treated with ruxolitinib-based regimen, including the first case of ruxolitinib combined with pegylated interferon (Peg-IFN), and we conduct a literature review. We found that ruxolitinib combined with Peg-IFN is an effective treatment option in the case of poor efficacy of ruxolitinib monotherapy.
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Affiliation(s)
- Yingxin Sun
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Yifeng Cai
- Department of Hematology, The Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Jia Chen
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Jiannong Cen
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Mingqing Zhu
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Jinlan Pan
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Depei Wu
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Aining Sun
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Suning Chen
- Department of Hematology, First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Soochow University, Suzhou, China.,Department of Thrombosis and Hemostasis, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
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Schwaab J, Naumann N, Luebke J, Jawhar M, Somervaille TCP, Williams MS, Frewin R, Jost PJ, Lichtenegger FS, La Rosée P, Storch N, Haferlach T, Horny HP, Fabarius A, Haferlach C, Burchert A, Hofmann WK, Cross NCP, Hochhaus A, Reiter A, Metzgeroth G. Response to tyrosine kinase inhibitors in myeloid neoplasms associated with PCM1-JAK2, BCR-JAK2 and ETV6-ABL1 fusion genes. Am J Hematol 2020; 95:824-833. [PMID: 32279331 DOI: 10.1002/ajh.25825] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 12/16/2022]
Abstract
We report on 18 patients with myeloid neoplasms and associated tyrosine kinase (TK) fusion genes on treatment with the TK inhibitors (TKI) ruxolitinib (PCM1-JAK2, n = 8; BCR-JAK2, n = 1) and imatinib, nilotinib or dasatinib (ETV6-ABL1, n = 9). On ruxolitinib (median 24 months, range 2-36 months), a complete hematologic response (CHR) and complete cytogenetic response (CCR) was achieved by five of nine and two of nine patients, respectively. However, ruxolitinib was stopped in eight of nine patients because of primary resistance (n = 3), progression (n = 3) or planned allogeneic stem cell transplantation (allo SCT, n = 2). At a median of 36 months (range 4-78 months) from diagnosis, five of nine patients are alive: four of six patients after allo SCT and one patient who remains on ruxolitinib. In ETV6-ABL1 positive patients, a durable CHR was achieved by four of nine patients (imatinib with one of five, nilotinib with two of three, dasatinib with one of one). Because of inadequate efficacy (lack of hematological and/or cytogenetic/molecular response), six of nine patients (imatinib, n = 5; nilotinib, n = 1) were switched to nilotinib or dasatinib. At a median of 23 months (range 3-60 months) from diagnosis, five of nine patients are in CCR or complete molecular response (nilotinib, n = 2; dasatinib, n = 2; allo SCT, n = 1) while two of nine patients have died. We conclude that (a) responses on ruxolitinib may only be transient in the majority of JAK2 fusion gene positive patients with allo SCT being an important early treatment option, and (b) nilotinib or dasatinib may be more effective than imatinib to induce durable complete remissions in ETV6-ABL1 positive patients.
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Affiliation(s)
- Juliana Schwaab
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicole Naumann
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Luebke
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Mohamad Jawhar
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Tim C P Somervaille
- Department of Haematology, The Christie NHS Foundation Trust, Manchester, UK
- Cancer Research UK Manchester Institute, Manchester, UK
| | - Mark S Williams
- Department of Haematology, The Christie NHS Foundation Trust, Manchester, UK
- Cancer Research UK Manchester Institute, Manchester, UK
| | - Rebecca Frewin
- Department of Pathology, Gloucester Royal Hospital, Gloucester, UK
| | - Philipp J Jost
- III. Medical Department, Hematology and Oncology, Klinikum rechts der Isar, Technical University Munich, Munchen, Bayern, Germany
| | | | - Paul La Rosée
- Klinik für Innere Medizin II, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Germany
| | - Nicola Storch
- Department of Hematology and Oncology, St. Vincenz Medical Centre, Limburg, Germany
| | | | | | - Alice Fabarius
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Andreas Burchert
- Department of Hematology, Oncology and Immunology, Philipps University Marburg, and University Medical Center Giessen and Marburg, Marburg, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicholas C P Cross
- Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Regional Genetics Laboratory, Salisbury, UK
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Andreas Reiter
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Georgia Metzgeroth
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
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Pardanani A, Tefferi A. Is there a role for JAK inhibitors in BCR-ABL1-negative myeloproliferative neoplasms other than myelofibrosis? Leuk Lymphoma 2015; 55:2706-11. [PMID: 25520049 DOI: 10.3109/10428194.2014.985159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Current data suggest that constitutively active JAK-STAT signaling plays a central role in the pathogenesis of BCR-ABL1-negative myeloproliferative neoplasms (MPNs), regardless of the specific underlying molecular abnormality. This observation provides strong rationale for use of JAK inhibitors for MPN treatment, and these drugs were first tested in myelofibrosis (MF) patients. Ruxolitinib, a JAK-1/2 inhibitor, is effective at controlling splenomegaly and constitutional symptoms, but has limited benefit in reversing bone marrow fibrosis or inducing complete or partial remissions. Ruxolitinib is currently in Phase 3 testing for treatment of hydroxyurea resistant/intolerant polycythemia vera (PV). Preliminary data reveals response rates of 60% for hematocrit control and 38% for spleen volume reduction per protocol-defined criteria, in addition to improving disease-related symptoms. These endpoints however have limited value as surrogates for long-term clinically relevant outcomes such as freedom-from-cardiovascular/thrombohemorrhagic events or time-to-hematological transformation, and the early crossover design of the aforementioned trial introduces limitations in terms of analysis of these latter endpoints. In contrast, other recent trials in PV have demonstrated the feasibility of using long-term clinically relevant outcomes as a primary endpoint. We also discuss the role of JAK inhibitors for treatment of CSF3RT618I-mutated chronic neutrophilic leukemia and hematologic malignancies with rearranged JAK2 gene.
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6
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Bain BJ, Ahmad S. Should myeloid and lymphoid neoplasms withPCM1-JAK2and other rearrangements ofJAK2be recognized as specific entities? Br J Haematol 2014; 166:809-17. [DOI: 10.1111/bjh.12963] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Barbara J. Bain
- Department of Haematology; St Mary's Hospital Campus of Imperial College London; St Mary's Hospital; London UK
| | - Shahzaib Ahmad
- Barts and the London School of Medicine and Dentistry; Queen Mary University of London; St Batholomew's Hospital; London UK
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7
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Rumi E, Milosevic JD, Casetti I, Dambruoso I, Pietra D, Boveri E, Boni M, Bernasconi P, Passamonti F, Kralovics R, Cazzola M. Efficacy of Ruxolitinib in Chronic Eosinophilic Leukemia Associated With a PCM1-JAK2 Fusion Gene. J Clin Oncol 2013; 31:e269-71. [DOI: 10.1200/jco.2012.46.4370] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Elisa Rumi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Jelena D. Milosevic
- Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Ilaria Casetti
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Irene Dambruoso
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Daniela Pietra
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Emanuela Boveri
- Institute of Anatomic Pathology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Marina Boni
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Paolo Bernasconi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo; and University of Pavia, Pavia, Italy
| | | | - Robert Kralovics
- Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Mario Cazzola
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo; and University of Pavia, Pavia, Italy
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8
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Masselli E, Mecucci C, Gobbi G, Carubbi C, Pierini V, Sammarelli G, Bonomini S, Prezioso L, Rossetti E, Caramatti C, Aversa F, Vitale M. Implication of MAPK1/MAPK3 signalling pathway in t(8;9)(p22;24)/PCM1-JAK2myelodysplastic/myeloproliferative neoplasms. Br J Haematol 2013; 162:563-6. [DOI: 10.1111/bjh.12392] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Cristina Mecucci
- Laboratory of Cytogenetic and Molecular Genetics; Haematology Unit; University of Perugia; Perugia; Italy
| | - Giuliana Gobbi
- Department of Biomedical, Biotechnological & Translational Sciences (S.Bi.Bi.T.); Unit of Human Anatomy & Histology; University of Parma; Parma; Italy
| | - Cecilia Carubbi
- Department of Biomedical, Biotechnological & Translational Sciences (S.Bi.Bi.T.); Unit of Human Anatomy & Histology; University of Parma; Parma; Italy
| | - Valentina Pierini
- Laboratory of Cytogenetic and Molecular Genetics; Haematology Unit; University of Perugia; Perugia; Italy
| | - Gabriella Sammarelli
- Department of Clinical and Experimental Medicine; Haematology and Bone Marrow Transplantation Unit; University of Parma; Parma; Italy
| | - Sabrina Bonomini
- Department of Clinical and Experimental Medicine; Haematology and Bone Marrow Transplantation Unit; University of Parma; Parma; Italy
| | - Lucia Prezioso
- Department of Clinical and Experimental Medicine; Haematology and Bone Marrow Transplantation Unit; University of Parma; Parma; Italy
| | - Elena Rossetti
- Department of Clinical and Experimental Medicine; Haematology and Bone Marrow Transplantation Unit; University of Parma; Parma; Italy
| | - Cecilia Caramatti
- Department of Clinical and Experimental Medicine; Haematology and Bone Marrow Transplantation Unit; University of Parma; Parma; Italy
| | - Franco Aversa
- Department of Clinical and Experimental Medicine; Haematology and Bone Marrow Transplantation Unit; University of Parma; Parma; Italy
| | - Marco Vitale
- Department of Biomedical, Biotechnological & Translational Sciences (S.Bi.Bi.T.); Unit of Human Anatomy & Histology; University of Parma; Parma; Italy
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Prochorec-Sobieszek M, Nasiłowska-Adamska B, Borg K, Kopeć I, Kos-Zakrzewska K, Juszczyński P, Warzocha K. Chronic eosinophilic leukemia with erythroblastic proliferation and the rare translocation t(8;9)(p22;p24) withPCM1–JAK2fusion gene: a distinct clinical, pathological and genetic entity with potential treatment target? Leuk Lymphoma 2012; 53:1824-7. [DOI: 10.3109/10428194.2012.661856] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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