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Bieniaszewska M, Sobieralski P, Leszczyńska A, Dutka M. Anagrelide in essential thrombocythemia: Efficacy and long-term consequences in young patient population. Leuk Res 2022; 123:106962. [PMID: 36183610 DOI: 10.1016/j.leukres.2022.106962] [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: 07/31/2022] [Revised: 09/03/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
Abstract
According to the current treatment recommendations, anagrelide, an oral antiplatelet agent, is recommended as a second-line therapy for patients with high-risk essential thrombocythemia experiencing intolerance or refractoriness to first-line approach, such as hydroxyurea or pegylated interferon alpha-2a. If there is a need for introduction of cytoreductive treatment in young patients with a perspective of lifelong exposure, both the efficacy and long-term outcomes should be known. We present the analysis of 48 young patients, diagnosed with essential thrombocythemia below the age of 60, who were exposed to anagrelide treatment for over 10 years. Our observations show that the highest proportion of complete remissions without adverse events and disease progression is seen in the JAK2-mutated patients. By evaluating the changes in hemoglobin concentration and serum erythropoietin throughout the study, we were able to reveal the development of progressive anemia, resulting from diminished susceptibility to erythropoietin and unrelated to bone marrow fibrosis, in patients harboring CALR mutation. Additionally, occurrence of new bone marrow fibrosis was confirmed in seven JAK2-unmutated patients at the end of the study. In summary, in young patient population, we recommend limiting the use of anagrelide to JAK2-mutated subgroup, reducing exposure time and underline the importance of periodic monitoring for the presence of bone marrow fibrosis.
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Affiliation(s)
- Maria Bieniaszewska
- Department of Hematology and Transplantology, Medical University of Gdańsk, Poland
| | - Patryk Sobieralski
- Department of Hematology and Transplantology, Medical University of Gdańsk, Poland.
| | | | - Magdalena Dutka
- Department of Hematology and Transplantology, Medical University of Gdańsk, Poland
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2
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Eldeweny S, Ibrahim H, Elsayed G, Samra M. MPL W515 L/K mutations in myeloproliferative neoplasms. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2019. [DOI: 10.1186/s43042-019-0039-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Myeloproliferative neoplasms (MPNs) describe a group of diseases involving the bone marrow (BM). Classical MPNs are classified into chronic myelogenous leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). This classification is based on the presence of Philadelphia (Ph) chromosome (BCR/ABL1). CML is BCR/ABL1-positive while PV, ET, and PMF are negative. JAK2 p. Val617Phe pathological variant is the most associated mutation in BCR/ABL1-negative MPNs. The frequency of JAK2 p. Val617Phe is 90–95% in PV patients, 50–60% in ET, and 40–50% in patients with PMF. Studies on MPL gene led to the revelation of a gain of function pathological variants in JAK2 p. Val617Phe-negative myeloproliferative neoplasms (MPNs). MPL p. W515 L/K pathological variants are the most common across all mutations in MPL gene. The prevalence of these pathological variants over the Egyptian population is not clear enough. In the present study, we aimed to investigate the prevalence of MPL p. W515 L/K pathological variants in the Philadelphia (Ph)-negative MPNs over the Egyptian population.
Results
We have tested 60 patients with Ph-negative MPNs for MPL p. W515 L/K pathological variants. Median age was 51 (22–73) years. No MPL p. W515 L/K pathological variants were detected among our patients. JAK2 p. Val617Phe in PV and PMF patients showed significantly lower frequency than other studies. Splenomegaly was significantly higher in ET patients compared to other studies.
Conclusion
MPL p. W515 L/K pathological variants are rare across the Egyptian Ph-negative MPNs, and further studies on a large number are recommended. MPN patients in Egypt are younger compared to different ethnic groups.
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Vu HA, Thao TT, Dong CV, Vuong NL, Chuong HQ, Van PNT, Nghia H, Binh NT, Dung PC, Xinh PT. Clinical and Hematological Relevance of JAK2V617F, CALR, and MPL Mutations in Vietnamese Patients with Essential Thrombocythemia. Asian Pac J Cancer Prev 2019; 20:2775-2780. [PMID: 31554376 PMCID: PMC6976857 DOI: 10.31557/apjcp.2019.20.9.2775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Indexed: 12/22/2022] Open
Abstract
Background: The picture of Vietnamese patients with essential thrombocythemia (ET) remains mostly undetermined. Our study intended to determine the frequency of JAK2V617F, CALR exon 9, and MPL exon 10 mutations as well as to analyze clinical characteristics associated with different mutational status in Vietnamese ET patients. Methods: We explored mutations of JAK2V617F, MPL, and CALR from 395 patients using allele specific oligonucleotide – polymerase chain reaction and Sanger sequencing techniques; then, the clinical and hematological features were compared according to mutation patterns. Results: We found that JAK2V617F, CALR exon 9, and MPL exon 10 mutations were present in 56.2%, 27.6%, and 1% of the 395 patients with ET, respectively. Twelve different types of CALR mutation were detected in 109 patients, with the CALR type 1 mutation (c.1099_1150del; L367fs*46) was the most common, followed by CALR type 2 mutation (c.1154_1155insTTGTC; K385fs*47). The JAK2V617F-positive patients had older age, higher white blood cell counts and higher hemoglobin levels but lower platelet counts than patients with CALR mutations or patients negative for triple tests. There was no significant difference regarding sex ratio, white blood cell counts, platelet counts and hemoglobin levels among CALR mutation subtypes. Conclusion: we reported high frequency of JAK2V617F, CALR, and MPL mutations in Vietnamese patients with ET and underscored the importance of combined genetic tests for diagnosis and classification of ET into different subtypes.
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Affiliation(s)
- Hoang Anh Vu
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tran Thi Thao
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Cao Van Dong
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Lam Vuong
- Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ho Quoc Chuong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Phan Nguyen Thanh Van
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Huynh Nghia
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. ,Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Tan Binh
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Phu Chi Dung
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Phan Thi Xinh
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. ,Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
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Patil VR, Chandrakala S, Mantri S, Patil R, Wasekar N, Jijina F. Mutation profile in Indian primary myelofibrosis patients and its clinical implications. South Asian J Cancer 2019; 8:186-188. [PMID: 31489296 PMCID: PMC6699232 DOI: 10.4103/sajc.sajc_276_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) characterized by abnormal proliferation of megakaryocytes, bone marrow fibrosis, and extramedullary hematopoiesis. We did mutation profile of 50 patients of PMF and tried to correlate it with initial clinical presentation of these patients. Materials and Methods: All new and follow up patients who were diagnosed as PMF based on WHO 2016 definition of PMF were included. Mutation profile of these patients including JAK2 V617F, JAK2 exon 12, CALR and MPL mutations was done and all clinical, demographic and laboratory details were recorded. Results: Total 50 patients were enrolled out of which 29 were males and 21 were females. Out of these patients, 32 (64%) were JAK2 positive, 13 (26%) were CALR positive, 1 (2%) were MPL positive and 4 (8%) were triple negative. As compared to JAK2+ve patients and triple negative group, CALR positive patients were younger, had lower total leucocyte count, larger spleen size, lower dynamic international prognostic scoring system (DIPSS) score and higher grade of fibrosis of marrow. Conclusion: This study depicts that incidence of JAK2 and CALR mutations in Indian PMF patients is fairly similar to that in rest of the world. CALR positive patients have better clinical parameters at presentation and have better prognosis as compared to JAK2 positive patients.
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Affiliation(s)
- Vinod R Patil
- Superspeciality Medical Officer, Department of Clinical Hematology, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - S Chandrakala
- Superspeciality Medical Officer, Department of Clinical Hematology, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Shruti Mantri
- Superspeciality Medical Officer, Department of Clinical Hematology, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Rajesh Patil
- Superspeciality Medical Officer, Department of Clinical Hematology, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Nilesh Wasekar
- Superspeciality Medical Officer, Department of Clinical Hematology, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Farah Jijina
- Superspeciality Medical Officer, Department of Clinical Hematology, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
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5
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Dogliotti I, Fava C, Serra A, Gottardi E, Daraio F, Carnuccio F, Giugliano E, Bocchia M, Saglio G, Rege-Cambrin G. CALR-positive myeloproliferative disorder in a patient with Ph-positive chronic myeloid leukemia in durable treatment-free remission: a case report. Stem Cell Investig 2017; 4:57. [PMID: 28725653 DOI: 10.21037/sci.2017.06.02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/24/2017] [Indexed: 01/15/2023]
Abstract
Current diagnostic criteria for Philadelphia-negative myeloproliferative neoplasia (MPN) have been redefined by the discovery of Janus kinase 2 (JAK2), myeloproliferative leukemia (MPL) and calreticulin (CALR) genetic alterations. Only few cases of coexistence of CALR-mutated MPN and Philadelphia-positive chronic myeloid leukemia (CML) have been described so far. Here we report the case of a patient with CML diagnosed in 2001, treated with imatinib and pegylated interferon (IFN) frontline. She reached complete molecular remission (CMR) and discontinued imatinib, maintaining treatment free remission. Due to persistent thrombocytosis, we repeated bone marrow (BM) analysis and diagnosed CARL-mutated essential thrombocythemia (ET). A CALR-positive clone was found to be present since 2001, and was unaffected by imatinib treatment, possibly representing a molecular abnormality arising at stem cell level.
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Affiliation(s)
- Irene Dogliotti
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Carmen Fava
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Anna Serra
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Enrico Gottardi
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Filomena Daraio
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Francesca Carnuccio
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Emilia Giugliano
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Monica Bocchia
- Department of Hematology, University of Siena, Siena, Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
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6
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Guglielmelli P, Pietra D, Pane F, Pancrazzi A, Cazzola M, Vannucchi AM, Tura S, Barosi G. Recommendations for molecular testing in classical Ph1-neg myeloproliferative disorders-A consensus project of the Italian Society of Hematology. Leuk Res 2017; 58:63-72. [PMID: 28460339 DOI: 10.1016/j.leukres.2017.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/26/2017] [Accepted: 04/20/2017] [Indexed: 12/21/2022]
Abstract
The discovery that Philadelphia-negative classical myeloproliferative neoplasms (MPNs) present with several molecular abnormalities, including the mostly represented JAK2V617F mutation, opened new horizons in the diagnosis, prognosis, and monitoring of these disorders. However, the great strides in the knowledge on molecular genetics need parallel progresses on the best approach to methods for detecting and reporting disease-associated mutations, and to shape the most effective and rationale testing pathway in the diagnosis, prognosis and monitoring of MPNs. The MPN taskforce of the Italian Society of Hematology (SIE) assessed the scientific literature and composed a framework of the best, possibly evidence-based, recommendations for optimal molecular methods as well as insights about the applicability and interpretation of those tests in the clinical practice, and clinical decision for testing MPNs patients. The issues dealt with: source of samples and nucleic acid template, the most appropriate molecular abnormalities and related detection methods required for diagnosis, prognosis, and monitoring of MPNs, how to report a diagnostic molecular test, calibration and quality control. For each of these issues, practice recommendations were provided.
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Affiliation(s)
- Paola Guglielmelli
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniela Pietra
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | | | - Alessandro Pancrazzi
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mario Cazzola
- Department of Molecular Medicine, University of Pavia, Pavia, Italy; Department of Haematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - Alessandro M Vannucchi
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Giovanni Barosi
- Center for the Study of Myelofibrosis, Biotechnology Research Area, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo, Pavia, Italy.
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7
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Limsuwanachot N, Rerkamnuaychoke B, Chuncharunee S, Pauwilai T, Singdong R, Rujirachaivej P, Chareonsirisuthigul T, Siriboonpiputtana T. Clinical and hematological relevance of JAK2 V617F and CALR mutations in BCR-ABL-negative ET patients. Hematology 2017; 22:599-606. [DOI: 10.1080/10245332.2017.1312736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- N. Limsuwanachot
- Human Genetics Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - B. Rerkamnuaychoke
- Human Genetics Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - S. Chuncharunee
- Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T. Pauwilai
- Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - R. Singdong
- Faculty of Medical Technology, Nakhonratchasima College, Nakhonratchasima, Thailand
| | - P. Rujirachaivej
- Division of Hematology, Clinical Pathology Laboratory, HRH Princess Maha Chakri Sirindhorn Medical Center, Nakhon Nayok, Thailand
| | - T. Chareonsirisuthigul
- Human Genetics Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T. Siriboonpiputtana
- Human Genetics Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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8
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Garbati MR, Welgan CA, Landefeld SH, Newell LF, Agarwal A, Dunlap JB, Chourasia TK, Lee H, Elferich J, Traer E, Rattray R, Cascio MJ, Press RD, Bagby GC, Tyner JW, Druker BJ, Dao KHT. Mutant calreticulin-expressing cells induce monocyte hyperreactivity through a paracrine mechanism. Am J Hematol 2016; 91:211-9. [PMID: 26573090 DOI: 10.1002/ajh.24245] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/12/2015] [Indexed: 01/05/2023]
Abstract
Mutations in the calreticulin gene (CALR) were recently identified in approximately 70-80% of patients with JAK2-V617F-negative essential thrombocytosis and primary myelofibrosis. All frameshift mutations generate a recurring novel C-terminus. Here we provide evidence that mutant calreticulin does not accumulate efficiently in cells and is abnormally enriched in the nucleus and extracellular space compared to wildtype calreticulin. The main determinant of these findings is the loss of the calcium-binding and KDEL domains. Expression of type I mutant CALR in Ba/F3 cells confers minimal IL-3-independent growth. Interestingly, expression of type I and type II mutant CALR in a nonhematopoietic cell line does not directly activate JAK/STAT signaling compared to wildtype CALR and JAK2-V617F expression. These results led us to investigate paracrine mechanisms of JAK/STAT activation. Here we show that conditioned media from cells expressing type I mutant CALR exaggerate cytokine production from normal monocytes with or without treatment with a toll-like receptor agonist. These effects are not dependent on the novel C-terminus. These studies offer novel insights into the mechanism of JAK/STAT activation in patients with JAK2-V617F-negative essential thrombocytosis and primary myelofibrosis.
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Affiliation(s)
- Michael R. Garbati
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Catherine A. Welgan
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Sally H. Landefeld
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Laura F. Newell
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Anupriya Agarwal
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Jennifer B. Dunlap
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Tapan K. Chourasia
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Hyunjung Lee
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Johannes Elferich
- Department of Biochemistry and Molecular Biology; Oregon Health and Science University; Portland Oregon
| | - Elie Traer
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Rogan Rattray
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Michael J. Cascio
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Richard D. Press
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Grover C. Bagby
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
| | - Jeffrey W. Tyner
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
- Department of Cell, Development, and Cancer Biology; Oregon Health and Science University, Knight Cancer Institute; Portland Oregon
| | - Brian J. Druker
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
- Department of Cell, Development, and Cancer Biology; Oregon Health and Science University, Knight Cancer Institute; Portland Oregon
- Howard Hughes Medical Institute, Oregon Health and Science University; Portland Oregon
| | - Kim-Hien T. Dao
- Knight Cancer Institute, Hematology and Medical Oncology, Oregon Health and Science University; Portland Oregon
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9
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Kong H, Liu Y, Luo S, Li Q, Wang Q. Frequency of Calreticulin (CALR) Mutation and Its Clinical Prognostic Significance in Essential Thrombocythemia and Primary Myelofibrosis: A Meta-analysis. Intern Med 2016; 55:1977-84. [PMID: 27477402 DOI: 10.2169/internalmedicine.55.6214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective As the calreticulin (CALR) mutation frequency is significantly associated with essential thrombocythemia (ET) and primary myelofibrosis (PMF), this mutation may be an important biomarker in patients with ET and PMF. Methods We performed a literature search until April 2015 and obtained 21 relevant studies. The outcome was pooled as the effect size by using the Stata software program. Results The CALR mutation frequencies in patients with ET and PMF were 19% and 22%, respectively. The CALR mutation ratio in Asian patients with ET was 23% and higher than that in European-American patients (16%). Moreover, the mutation ratio in Asian patients with PMF was lower (21%) than that in European-American patients (23%). A slight trend toward fibrotic transformation was found in ET with CALR mutations, whereas leukemic transformation was not significant in patients with ET or PMF with CALR mutations. Conclusion CALR mutations significantly influence the incident of ET as demonstrated by the meta-analysis.
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Affiliation(s)
- Hao Kong
- Key Laboratory of Biomedical Engineering & Technology of Shandong High School, Qilu Medical University, China
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10
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Shuly Y, Nagar M, Ben-Asaf L, Kneller A, Steinberg DM, Amariglio N, Salomon O. Calreticulin mutation burden--is it a stable clone in patients with essential thrombocythemia and myelofibrosis? Blood Cells Mol Dis 2015; 55:281-3. [PMID: 26460248 DOI: 10.1016/j.bcmd.2015.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 07/17/2015] [Accepted: 07/17/2015] [Indexed: 11/25/2022]
Abstract
Calreticulin mutation represents the second most frequent mutation after JAK2 V617F in myeloproliferative disorder and is considered to be a driving mutation. Herein the mutation burden was evaluated in patients with essential thrombocythemia or myelofibrosis and found to increase by 5.7% over time unrelated to the time elapsed from the initial to the final positive test. The longer the course of the disease when first tested (range 0-30 years, mean 7.9 years) the lower mutation burden was observed. The mutated clone was larger in type II in comparison with type I mutation when first tested but the difference in mutation burden from the final to the first positive test was significantly higher in those with type I. Similarly, the difference in mutation burden was higher in patients with essential thrombocythemia reaching almost 8% in comparison to 1.3% in post-essential thrombocythemia myelofibrosis. Thus a repeat calreticulin quantitative test is not warranted.
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Affiliation(s)
- Yulia Shuly
- Hematology Laboratory, Sheba Medical Center, Tel Hashomer, Israel
| | - Meital Nagar
- Hematology Laboratory, Sheba Medical Center, Tel Hashomer, Israel
| | - Lior Ben-Asaf
- Hematology Laboratory, Sheba Medical Center, Tel Hashomer, Israel
| | - Abraham Kneller
- Hematology Department, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David M Steinberg
- Department of Statistics and Operations Research, Faculty of Exact Sciences, Tel Aviv University, Israel
| | | | - Ophira Salomon
- Thrombosis and Hemostasis Unit, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Israel.
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11
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Lin Y, Liu E, Sun Q, Ma J, Li Q, Cao Z, Wang J, Jia Y, Zhang H, Song Z, Ai X, Shi L, Feng X, Li C, Wang J, Ru K. The Prevalence of JAK2, MPL, and CALR Mutations in Chinese Patients With BCR-ABL1-Negative Myeloproliferative Neoplasms. Am J Clin Pathol 2015; 144:165-71. [PMID: 26071474 DOI: 10.1309/ajcpalp51xdixddv] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To evaluate the mutation frequency of JAK2 V617F, JAK2 exon 12, MPL exon 10, and CALR exon 9 and the value of the combined tests in the diagnosis of BCR-ABL1-negative myeloproliferative neoplasms (MPNs). METHODS In the current study, mutations of JAK2 V617F, JAK2 exon 12, MPL exon 10, and CALR exon 9 were analyzed in 929 Chinese patients with BCR-ABL1-negative MPN, including 234 cases of polycythemia vera (PV), 428 ETs, 187 PMFs, and 80 unclassifiable MPNs (MPN-Us). RESULTS Our result showed that the positive rate of any of four mutations in patients with PV, ET, PMF, and MPN-U was 89.3%, 83.4%, 87.2%, and 77.5%, respectively, which significantly improved the diagnostic rate, especially in ET and PMF. Meanwhile, we also found that the patients without any of four mutations were younger than those with one or more mutations. Unexpectedly, the coexistence of JAK2 V617F and CALR exon 9 was identified in six (0.6%) patients, and JAK2 V617F and MPL exon 10 were present simultaneously in two (0.2%) patients. In addition, we also identified several novel mutation types in CALR exon 9. CONCLUSIONS The combined genetic tests of JAK2 V617F, JAK2 exon 12, MPL exon 10, and CALR exon 9 help improve the diagnostic rate for BCR-ABL1-negative MPN.
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12
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Cook JR. Searching for CALRity in myeloproliferative neoplasms. Am J Clin Pathol 2015; 143:617-9. [PMID: 25873492 DOI: 10.1309/ajcpzfwdm4gdtci8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- James R Cook
- From the Cleveland Clinic Foundation, Cleveland, OH
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Yonal-Hindilerden I, Daglar-Aday A, Akadam-Teker B, Yilmaz C, Nalcaci M, Yavuz AS, Sargin D. The Burden of JAK2V617F Mutated Allele in Turkish Patients With Myeloproliferative Neoplasms. J Clin Med Res 2015; 7:161-70. [PMID: 25584101 PMCID: PMC4285062 DOI: 10.14740/jocmr2047w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Studies regarding the impact of JAK2V617F allele burden on phenotypic properties and clinical course in Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs) have reported variable results. We aimed to analyze the association of mutated JAK2V617F allele burden with laboratory characteristics and clinical phenotype in Turkish patients (107 essential thrombocythemia (ET) and 77 primary myelofibrosis (PMF)). METHODS Peripheral blood samples of 184 patients with Ph-negative MPNs were analyzed for JAK2V617F allele status and burden. JAK2 MutaScreen assay (Ipsogen, Luminy Biotech, Marseille, France) was used to detect the JAK2V617F status and quantitative JAK2V617F allele burdens in genomic DNA using TaqMan allelic discrimination. RESULTS Frequency of JAK2V617F-positive patients with high mutation load (allele burden > 50%) was higher in PMF compared to ET (23.4% and 4.7%, respectively; P = 0.001). We found significant association between ET patients with high JAK2V617F allele burden and lower hemoglobin (Hgb) and hematocrit (Hct), higher LDH levels and more prevalent massive splenomegaly (P = 0.001, P = 0.001, P = 0.012 and P = 0.015, respectively). ET patients with high mutation load displayed higher prevalence of bleeding compared to low mutation load and wild-type mutational status (P = 0.003). Rate of DVT was significantly higher in ET patients with mutant allele burden in upper half compared to lower half and wild-type (P = 0.029). We observed significant association between PMF patients with high JAK2V617F allele burden and higher Hgb, Hct levels and leukocyte counts (P = 0.003, P = 0.021 and P = 0.001, respectively). CONCLUSIONS Our study demonstrated JAK2V617F allele burden correlates with clinical features in ET and PMF. We conclude quantification of JAK2V617F mutation contributes to the workup of Ph-negative MPNs.
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Affiliation(s)
- Ipek Yonal-Hindilerden
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Aynur Daglar-Aday
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Basak Akadam-Teker
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Ceylan Yilmaz
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Meliha Nalcaci
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Akif Selim Yavuz
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Deniz Sargin
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
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Wu Z, Zhang C, Ma X, Guan M. Clinical relevance between CALR mutation and myeloproliferative neoplasms. Stem Cell Investig 2015; 2:4. [PMID: 27358872 DOI: 10.3978/j.issn.2306-9759.2015.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/20/2015] [Indexed: 11/14/2022]
Abstract
In late 2013, somatic mutations in calreticulin (CALR), mainly those involving insertions and deletions in exon 9, attracted the great attention of hematologists and researchers. These JAK2- and MPL- mutual exclusive mutations enjoy a favorable specificity and prevalence (20-30%) in patients with essential thrombocythemia (ET) and primary myelofibrosis (PMF), suggesting promise for these mutations in disease management. Moreover, these genetic variations are now also considered as a group of independent risk factors for disease prognosis. In this mini-review, we will document the value of CALR mutations in disease diagnosis, prognosis, and therapeutic strategy selection, and we will discuss current advances in methods to detect these mutations.
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Affiliation(s)
- Zhiyuan Wu
- 1 Department of Laboratory Medicine, Huashan Hospital North, Shanghai Medical College, Fudan University, Shanghai 201907, China ; 2 Central Laboratory, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China ; 3 Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Chen Zhang
- 1 Department of Laboratory Medicine, Huashan Hospital North, Shanghai Medical College, Fudan University, Shanghai 201907, China ; 2 Central Laboratory, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China ; 3 Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Xiaochao Ma
- 1 Department of Laboratory Medicine, Huashan Hospital North, Shanghai Medical College, Fudan University, Shanghai 201907, China ; 2 Central Laboratory, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China ; 3 Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Ming Guan
- 1 Department of Laboratory Medicine, Huashan Hospital North, Shanghai Medical College, Fudan University, Shanghai 201907, China ; 2 Central Laboratory, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China ; 3 Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15260, USA
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