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Narlı Özdemir Z, İpek Y, Patır P, Ermiş G, Çiftçiler R, Özmen D, Baysal M, Gürsoy V, Yıldızhan E, Güven S, Ercan T, Elibol T, Mersin S, Genç E, Davulcu EA, Karakuş V, Erkut N, Güneş G, Diz Küçükkaya R, Eşkazan AE. Impact of CALR and JAK2V617F Mutations on Clinical Course and Disease Outcomes in Essential Thrombocythemia: A Multicenter Retrospective Study in Turkish Patients. Turk J Haematol 2024; 41:26-36. [PMID: 38433449 PMCID: PMC10918406 DOI: 10.4274/tjh.galenos.2024.2023.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/11/2024] [Indexed: 03/05/2024] Open
Abstract
Objective In this study, we investigated the effects of calreticulin (CALR) and JAK2V617F mutational status on clinical course and disease outcomes in Turkish patients with essential thrombocythemia (ET). Materials and Methods Seventeen centers from Türkiye participated in the study and CALR- and JAK2V617F-mutated ET patients were evaluated retrospectively. Results A total of 302 patients were included, of whom 203 (67.2%) and 99 (32.8%) were JAK2V617F- and CALR-positive, respectively. CALR-mutated patients were significantly younger (51 years vs. 57.5 years, p=0.03), with higher median platelet counts (987x109/L vs. 709x109/L, p<0.001) and lower median hemoglobin levels (13.1 g/dL vs. 14.1 g/dL, p<0.001) compared to JAK2V617F-mutated patients. Thromboembolic events (TEEs) occurred in 54 patients (17.9%), 77.8% of which were arterial. Compared to CALR mutation, JAK2V617F was associated with a higher risk of thrombosis (8.1% vs. 22.7%, p=0.002). Rates of transformation to myelofibrosis (MF) and leukemia were 4% and 0.7%, respectively, and these rates were comparable between JAK2V617F- and CALR-mutated cases. The estimated overall survival (OS) and MF-free survival of the entire cohort were 265.1 months and 235.7 months, respectively. OS and MF-free survival durations were similar between JAK2V617F- and CALR-mutated patients. Thrombosis-free survival (TFS) was superior in CALR-mutated patients compared to JAK2V617F-positive patients (5-year TFS: 90% vs. 71%, respectively; p=0.001). Age at diagnosis was an independent factor affecting the incidence of TEEs. Conclusion In our ET cohort, CALR mutations resulted in higher platelet counts and lower hemoglobin levels than JAK2V617F and were associated with younger age at diagnosis. JAK2V617F was strongly associated with thrombosis and worse TFS. Hydroxyurea was the most preferred cytoreductive agent for patients with high thrombosis risk.
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Affiliation(s)
| | - Yıldız İpek
- Kartal Dr. Lüfti Kırdar City Hospital, Clinic of Hematology, İstanbul, Türkiye
| | - Püsem Patır
- Antalya Training and Research Hospital, Clinic of Hematology, Antalya, Türkiye
| | - Gözde Ermiş
- Karadeniz Technical University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Türkiye
| | - Rafiye Çiftçiler
- Selçuk University Faculty of Medicine, Department of Hematology, Konya, Türkiye
| | - Deniz Özmen
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Türkiye
| | - Mehmet Baysal
- Ali Osman Sönmez Oncology Hospital, Clinic of Hematology, Bursa, Türkiye
| | - Vildan Gürsoy
- Bursa City Hospital, Clinic of Orthopedics and Traumatology, Bursa, Türkiye
| | - Esra Yıldızhan
- Kayseri City Hospital, Clinic of Hematology, Kayseri, Türkiye
| | - Serkan Güven
- Mehmet Akif Ersoy State Hospital, Clinic of Hematology, Çanakkale, Türkiye
| | - Tarık Ercan
- Haydarpaşa Numune Training and Research Hospital, Clinic of Hematology, İstanbul, Türkiye
| | - Tayfun Elibol
- Medeniyet University Göztepe Training and Research Hospital, Clinic of Hematology, İstanbul, Türkiye
| | - Sinan Mersin
- Muğla Sıtkı Koçman University Training and Research Hospital, Clinic of Hematology, Muğla, Türkiye
| | - Eylem Genç
- Tekirdağ Dr. İsmail Fehmi Cumalıoğlu City Hospital, Clinic of Hematology, Tekirdağ, Türkiye
| | - Eren Arslan Davulcu
- University of Health Sciences Türkiye, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Clinic of Hematology, İstanbul, Türkiye
| | - Volkan Karakuş
- Antalya Training and Research Hospital, Clinic of Hematology, Antalya, Türkiye
| | - Nergiz Erkut
- Karadeniz Technical University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Türkiye
| | - Gürsel Güneş
- University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinic of Hematology, Ankara, Türkiye
| | - Reyhan Diz Küçükkaya
- İstanbul University Faculty of Science, Department of Molecular Biology and Genetics, İstanbul, Türkiye
| | - Ahmet Emre Eşkazan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Türkiye
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Neupane N, Low SK, Kharel H, Bhattarai S, Thapa S, Mahmoud A, Pokhrel NB, Ammad Ud Din M, Kouides P. Comparative thrombotic risk associated with CALR1, CALR2, and JAK2 V617F mutations in essential thrombocythemia. Am J Hematol 2024; 99:E26-E28. [PMID: 37950856 DOI: 10.1002/ajh.27148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 11/13/2023]
Affiliation(s)
- Niraj Neupane
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA
| | - Soon K Low
- Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Himal Kharel
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA
| | | | - Sangharsha Thapa
- Department of Medicine, Westchester Medical Center, New York Medical College, Westchester, New York, USA
| | - Amir Mahmoud
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA
| | - Nishant B Pokhrel
- Department of Internal Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
| | | | - Peter Kouides
- Department of Hematology, Lipson Cancer Institute, Rochester General Hospital, Rochester, New York, USA
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Zhang M, Xiao J, Liu J, Bai X, Zeng X, Zhang Z, Liu F. Calreticulin as a marker and therapeutic target for cancer. Clin Exp Med 2023; 23:1393-1404. [PMID: 36335525 DOI: 10.1007/s10238-022-00937-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/27/2022] [Indexed: 11/07/2022]
Abstract
Calreticulin (CRT) is a multifunctional protein found within the endoplasmic reticulum (ER). In addition, CRT participates in the formation and development of tumors and promotes the proliferation and migration of tumor cells. When a malignant tumor occurs in the human body, cancer cells that die from immunogenic cell death (ICD) expose CRT on their surface, and CRT that is transferred to the cell surface represents an "eat me" signal, which promotes dendritic cells to phagocytose the tumor cells, thereby increasing the sensitivity of tumors to anticancer immunotherapy. Expression of CRT in tumor tissues is higher than in normal tissues and is associated with disease progression in many malignant tumors. Thus, the dysfunctional production of CRT can promote tumorigenesis because it disturbs not only the balance of healthy cells but also the body's immune surveillance. CRT may be a diagnostic marker and a therapeutic target for cancer, which is discussed extensively in this review.
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Affiliation(s)
- Meilan Zhang
- Department of Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Juan Xiao
- Department of Otolaryngology, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China
| | - Jiangrong Liu
- Department of Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Xue Bai
- Department of Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Xuemei Zeng
- Department of Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Zhiwei Zhang
- Department of Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
| | - Feng Liu
- Department of Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
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Abdelghani M, Hammami H, Zidi W, Amouri H, Othmen HBH, Farrah A, Menif S. Hematological relevance of JAK2 V617F and calreticulin mutations in Tunisian patients with essential thrombocythemia. J Clin Lab Anal 2022; 36:e24522. [PMID: 35754115 PMCID: PMC9396186 DOI: 10.1002/jcla.24522] [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: 10/20/2021] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/14/2022] Open
Abstract
Background The genetic investigation of essential thrombocythemia(ET) has highlighted the presence of driver mutations in ET. Janus kinase JAK2V617F and calreticulin(CALR) mutations are the most frequent driver mutations and have significantly improved the molecular diagnosis of ET. The impact of genetic heterogeneity on clinical features has not been fully elucidated. This is the first study which aimed to determine the frequency of JAK2V617F and CALR exon9 mutations in Tunisian ET patients and to establish the correlation between hematological characteristics and mutational status. Methods This study included Tunisian patients suspected with ET and was conducted between September 2017 and March 2021. Genomic DNA of patients was isolated from peripheral blood samples. JAK2V617F was detected by AS‐PCR and CALR mutations were detected by PCR/direct sequencing. Clinical and hematological characteristics were also analyzed. Results Two hundred and fifty ET patients were enrolled in this study. JAK2V617F mutation was found in 166/250 (66.4%) of patients, whereas CALR mutations were detected in 27/84 (32.1%) patients without JAK2V617F. Compared with JAK2V617F‐positive patients, those with CALR mutations showed lower hemoglobin level and lower leucocytes count (p = 0.007 and p = 0.004,respectively). CALR type 2 was the most frequent mutation of CALR detected in 55.55% of CALR mutated. Six of seven patients with thrombotic events harbored JAK2V617F mutation. Conclusion The prevalence of driver mutations JAK2V617F or CALR mutations was 77.2% in Tunisian ET patients. Moreover, patients with JAK2 V617F mutation had a higher risk of thrombosis. The mutational status is necessary to improve the diagnosis and contribute to the therapeutic decisions.
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Affiliation(s)
- Maroua Abdelghani
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Faculty of Mathematics, Physics and Natural Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Haifa Hammami
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Faculty of Mathematics, Physics and Natural Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wiem Zidi
- Laboratory of Biochemistry, Rabta Hospital, Tunis, Tunisia
| | - Hassiba Amouri
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Hind Ben Hadj Othmen
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ahlem Farrah
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Samia Menif
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Production and Characterization of Peptide Antibodies to the C-Terminal of Frameshifted Calreticulin Associated with Myeloproliferative Diseases. Int J Mol Sci 2022; 23:ijms23126803. [PMID: 35743246 PMCID: PMC9223637 DOI: 10.3390/ijms23126803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/04/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022] Open
Abstract
Myeloproliferative Neoplasms (MPNs) constitute a group of rare blood cancers that are characterized by mutations in bone marrow stem cells leading to the overproduction of erythrocytes, leukocytes, and thrombocytes. Mutations in calreticulin (CRT) genes may initiate MPNs, causing a novel variable polybasic stretch terminating in a common C-terminal sequence in the frameshifted CRT (CRTfs) proteins. Peptide antibodies to the mutated C-terminal are important reagents for research in the molecular mechanisms of MPNs and for the development of new diagnostic assays and therapies. In this study, eight peptide antibodies targeting the C-terminal of CRTfs were produced and characterised by modified enzyme-linked immunosorbent assays using resin-bound peptides. The antibodies reacted to two epitopes: CREACLQGWTE for SSI-HYB 385-01, 385-02, 385-03, 385-04, 385-07, 385-08, and 385-09 and CLQGWT for SSI-HYB 385-06. For the majority of antibodies, the residues Cys1, Trp9, and Glu11 were essential for reactivity. SSI-HYB 385-06, with the highest affinity, recognised recombinant CRTfs produced in yeast and the MARIMO cell line expressing CRTfs when examined in Western immunoblotting. Moreover, SSI-HYB 385-06 occasionally reacted to CRTfs from MPN patients when analysed by flow cytometry. The characterized antibodies may be used to understand the role of CRTfs in the pathogenesis of MPNs and to design and develop new diagnostic assays and therapeutic targets.
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