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Chia YC, Siti Asmaa MJ, Ramli M, Woon PY, Johan MF, Hassan R, Islam MA. Molecular Genetics of Thrombotic Myeloproliferative Neoplasms: Implications in Precision Oncology. Diagnostics (Basel) 2023; 13:163. [PMID: 36611455 PMCID: PMC9818412 DOI: 10.3390/diagnostics13010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 01/06/2023] Open
Abstract
Classical BCR-ABL-negative myeloproliferative neoplasms (MPN) include polycythaemia vera, essential thrombocythaemia, and primary myelofibrosis. Unlike monogenic disorders, a more complicated series of genetic mutations are believed to be responsible for MPN with various degrees of thromboembolic and bleeding complications. Thrombosis is one of the early manifestations in patients with MPN. To date, the driver genes responsible for MPN include JAK2, CALR, MPL, TET2, ASXL1, and MTHFR. Affords have been done to elucidate these mutations and the incidence of thromboembolic events. Several lines of evidence indicate that mutations in JAK2, MPL, TET2 and ASXL1 gene and polymorphisms in several clotting factors (GPIa, GPIIa, and GPIIIa) are associated with the occurrence and prevalence of thrombosis in MPN patients. Some polymorphisms within XRCC1, FBG, F2, F5, F7, F12, MMP9, HPA5, MTHFR, SDF-1, FAS, FASL, TERT, ACE, and TLR4 genes may also play a role in MPN manifestation. This review aims to provide an insightful overview on the genetic perspective of thrombotic complications in patients with MPN.
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Affiliation(s)
- Yuh Cai Chia
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mat Jusoh Siti Asmaa
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Marini Ramli
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Peng Yeong Woon
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien 97004, Taiwan
| | - Muhammad Farid Johan
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Rosline Hassan
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Md Asiful Islam
- Department Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
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Chia YC, Ramli M, Woon PY, Johan MF, Hassan R, Islam MA. WITHDRAWN: Molecular genetics of thrombotic myeloproliferative neoplasms: Implications in precision oncology. Genes Dis 2021. [DOI: 10.1016/j.gendis.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Orlova A, Wingelhofer B, Neubauer HA, Maurer B, Berger-Becvar A, Keserű GM, Gunning PT, Valent P, Moriggl R. Emerging therapeutic targets in myeloproliferative neoplasms and peripheral T-cell leukemia and lymphomas. Expert Opin Ther Targets 2017; 22:45-57. [PMID: 29148847 PMCID: PMC5743003 DOI: 10.1080/14728222.2018.1406924] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Hematopoietic neoplasms are often driven by gain-of-function mutations of the JAK-STAT pathway together with mutations in chromatin remodeling and DNA damage control pathways. The interconnection between the JAK-STAT pathway, epigenetic regulation or DNA damage control is still poorly understood in cancer cell biology. Areas covered: Here, we focus on a broader description of mutational insights into myeloproliferative neoplasms and peripheral T-cell leukemia and lymphomas, since sequencing efforts have identified similar combinations of driver mutations in these diseases covering different lineages. We summarize how these pathways might be interconnected in normal or cancer cells, which have lost differentiation capacity and drive oncogene transcription. Expert opinion: Due to similarities in driver mutations including epigenetic enzymes, JAK-STAT pathway activation and mutated checkpoint control through TP53, we hypothesize that similar therapeutic approaches could be of benefit in these diseases. We give an overview of how driver mutations in these malignancies contribute to hematopoietic cancer initiation or progression, and how these pathways can be targeted with currently available tools.
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Affiliation(s)
- Anna Orlova
- a Institute of Animal Breeding and Genetics , University of Veterinary Medicine Vienna , Vienna , Austria.,b Ludwig Boltzmann Institute for Cancer Research , Vienna , Austria
| | - Bettina Wingelhofer
- a Institute of Animal Breeding and Genetics , University of Veterinary Medicine Vienna , Vienna , Austria.,b Ludwig Boltzmann Institute for Cancer Research , Vienna , Austria
| | - Heidi A Neubauer
- a Institute of Animal Breeding and Genetics , University of Veterinary Medicine Vienna , Vienna , Austria.,b Ludwig Boltzmann Institute for Cancer Research , Vienna , Austria
| | - Barbara Maurer
- c Institute of Pharmacology and Toxicology , University of Veterinary Medicine Vienna , Vienna , Austria
| | - Angelika Berger-Becvar
- g Department of Chemical & Physical Sciences , University of Toronto Mississauga , Mississauga , Canada.,h Department of Chemistry , University of Toronto , Toronto , Canada
| | - György Miklós Keserű
- d Medicinal Chemistry Research Group, Research Centre for Natural Sciences , Hungarian Academy of Sciences , Budapest , Hungary
| | - Patrick T Gunning
- g Department of Chemical & Physical Sciences , University of Toronto Mississauga , Mississauga , Canada.,h Department of Chemistry , University of Toronto , Toronto , Canada
| | - Peter Valent
- e Department of Internal Medicine I, Division of Hematology and Hemostaseology , Medical University of Vienna , Vienna , Austria.,f Ludwig Boltzmann-Cluster Oncology , Medical University of Vienna , Vienna , Austria
| | - Richard Moriggl
- a Institute of Animal Breeding and Genetics , University of Veterinary Medicine Vienna , Vienna , Austria.,b Ludwig Boltzmann Institute for Cancer Research , Vienna , Austria.,i Medical University Vienna , Vienna , Austria
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McPherson S, McMullin MF, Mills K. Epigenetics in Myeloproliferative Neoplasms. J Cell Mol Med 2017; 21:1660-1667. [PMID: 28677265 PMCID: PMC5571538 DOI: 10.1111/jcmm.13095] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 12/15/2016] [Indexed: 12/16/2022] Open
Abstract
A decade on from the description of JAK2 V617F, the MPNs are circumscribed by an increasingly intricate landscape. There is now evidence that they are likely the result of combined genetic dysregulation, with several mutated genes involved in the regulation of epigenetic mechanisms. Epigenetic changes are not due to a change in the DNA sequence but are reversible modifications that dictate the way in which genes may be expressed (or silenced). Among the epigenetic mechanisms, DNA methylation is probably the best described. Currently known MPN‐associated mutations now include JAK2, MPL, LNK, CBL, CALR, TET2, ASXL1, IDH1, IDH2, IKZF1 and EZH2. Enhancing our knowledge about the mutation profile of patients may allow them to be stratified into risk groups which would aid clinical decision making. Ongoing work will answer whether the use of epigenetic therapies as alterative pathway targets in combination with JAK inhibitors may be more effective than single agent treatment.
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Affiliation(s)
- Suzanne McPherson
- Blood Cancer Research Group, Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast, UK
| | - Mary Frances McMullin
- Centre for Medical Education, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - Ken Mills
- Blood Cancer Research Group, Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast, UK
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Them NC, Bagienski K, Berg T, Gisslinger B, Schalling M, Chen D, Buxhofer‐Ausch V, Thaler J, Schloegl E, Gastl GA, Wolf D, Strecker K, Egle A, Melchardt T, Burgstaller S, Willenbacher E, Zagrijtschuk O, Klade C, Greil R, Gisslinger H, Kralovics R. Molecular responses and chromosomal aberrations in patients with polycythemia vera treated with peg-proline-interferon alpha-2b. Am J Hematol 2015; 90:288-94. [PMID: 25545244 PMCID: PMC4657499 DOI: 10.1002/ajh.23928] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 12/20/2014] [Indexed: 01/22/2023]
Abstract
Fifty-one polycythemia vera (PV) patients were enrolled in the phase I/II clinical study PEGINVERA to receive a new formulation of pegylated interferon alpha (peg-proline-IFNα-2b, AOP2014/P1101). Peg-proline-IFNα-2b treatment led to high response rates on both hematologic and molecular levels. Hematologic and molecular responses were achieved for 46 and 18 patients (90 and 35% of the whole cohort), respectively. Although interferon alpha (IFNα) is known to be an effective antineoplastic therapy for a long time, it is currently not well understood which genetic alterations influence therapeutic outcomes. Apart from somatic changes in specific genes, large chromosomal aberrations could impact responses to IFNα. Therefore, we evaluated the interplay of cytogenetic changes and IFNα responses in the PEGINVERA cohort. We performed high-resolution SNP microarrays to analyze chromosomal aberrations prior and during peg-proline-IFNα-2b therapy. Similar numbers and types of chromosomal aberrations in responding and non-responding patients were observed, suggesting that peg-proline-IFNα-2b responses are achieved independently of chromosomal aberrations. Furthermore, complete cytogenetic remissions were accomplished in three patients, of which two showed more than one chromosomal aberration. These results imply that peg-proline-IFNα-2b therapy is an effective drug for PV patients, possibly including patients with complex cytogenetic changes. Am. J. Hematol. 90:288–294, 2015. © 2014 The Authors. American Journal of Hematology published by Wiley Periodicals, Inc.
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Affiliation(s)
- Nicole C.C. Them
- CeMM Research Center for Molecular Medicine of the Austrian Academy of SciencesVienna Austria
| | - Klaudia Bagienski
- CeMM Research Center for Molecular Medicine of the Austrian Academy of SciencesVienna Austria
| | - Tiina Berg
- CeMM Research Center for Molecular Medicine of the Austrian Academy of SciencesVienna Austria
| | - Bettina Gisslinger
- Department of Internal Medicine IDivision of Hematology and Blood CoagulationMedical University of ViennaVienna Austria
| | - Martin Schalling
- Department of Internal Medicine IDivision of Hematology and Blood CoagulationMedical University of ViennaVienna Austria
| | - Doris Chen
- CeMM Research Center for Molecular Medicine of the Austrian Academy of SciencesVienna Austria
| | - Veronika Buxhofer‐Ausch
- 2nd Medical DepartmentSozialmedizinisches Zentrum Ost—DonauspitalVienna Austria
- Interne 1 Hemato‐OncologyKrankenhaus Der Elisabethinen LinzLinz Austria
| | - Josef Thaler
- Department of Internal Medicine IVWels‐Grieskirchen HospitalWels Austria
| | | | - Guenther A. Gastl
- Department of Internal Medicine V Haematology & OncologyInnsbruck Medical UniversityInnsbruck Austria
| | - Dominik Wolf
- Department of Internal Medicine V Haematology & OncologyInnsbruck Medical UniversityInnsbruck Austria
- Medical Clinic IIIOncologyHematology and RheumatologyUniversity Clinic of Bonn (UKB)Bonn Germany
| | - Karin Strecker
- 2nd Medical DepartmentSozialmedizinisches Zentrum Ost—DonauspitalVienna Austria
| | - Alexander Egle
- Laboratory for Immunological and Molecular Cancer ResearchDepartment of Internal Medicine III with HematologyMedical OncologyHemostaseologyInfectious DiseasesRheumatologyOncologic Center, Paracelsus Medical UniversitySalzburg Austria
| | - Thomas Melchardt
- Laboratory for Immunological and Molecular Cancer ResearchDepartment of Internal Medicine III with HematologyMedical OncologyHemostaseologyInfectious DiseasesRheumatologyOncologic Center, Paracelsus Medical UniversitySalzburg Austria
| | - Sonja Burgstaller
- Department of Internal Medicine IVWels‐Grieskirchen HospitalWels Austria
| | - Ella Willenbacher
- Department of Internal Medicine V Haematology & OncologyInnsbruck Medical UniversityInnsbruck Austria
| | | | | | - Richard Greil
- Laboratory for Immunological and Molecular Cancer ResearchDepartment of Internal Medicine III with HematologyMedical OncologyHemostaseologyInfectious DiseasesRheumatologyOncologic Center, Paracelsus Medical UniversitySalzburg Austria
| | - Heinz Gisslinger
- Department of Internal Medicine IDivision of Hematology and Blood CoagulationMedical University of ViennaVienna Austria
| | - Robert Kralovics
- CeMM Research Center for Molecular Medicine of the Austrian Academy of SciencesVienna Austria
- Department of Internal Medicine IDivision of Hematology and Blood CoagulationMedical University of ViennaVienna Austria
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Polycythemia Vera. Crit Care Nurs Q 2013; 36:228-32. [DOI: 10.1097/cnq.0b013e318284153b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Spasovski V, Tosic N, Nikcevic G, Stojiljkovic M, Zukic B, Radmilovic M, Karan-Djurasevic T, Srzentic S, Colovic M, Pavlovic S. The influence of novel transcriptional regulatory element in intron 14 on the expression of Janus kinase 2 gene in myeloproliferative neoplasms. J Appl Genet 2012. [PMID: 23188718 DOI: 10.1007/s13353-012-0125-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The expression of Janus kinase 2 (JAK2) gene is altered in myeloproliferative neoplasms (MPN) and the regulation of transcription could be a mechanism that modulates JAK2 gene expression. We analyzed the transcriptional potential of single-nucleotide polymorphism (SNP) rs12343867 T > C in JAK2 intron 14, tagging 46/1 haplotype, and its influence on JAK2 gene expression. Functional analysis of JAK2 intron 14 was performed using the pBLCAT5 reporter system in K562 cells. Identification of the proteins binding to the intron 14 regulatory element was accomplished by electrophoretic mobility shift assay (EMSA) and supershift assays. Quantification of the expression of JAK2 gene in a cohort of 51 MPN patients and 12 healthy controls was performed by real-time quantitative polymerase chain reaction (RQ-PCR). Functional analysis revealed that the intronic DNA element harboring SNP rs12343867 T > C acts as a transcriptional repressor in vitro. The repressor activity was significantly attenuated by the presence of nucleotide C. Supershift analysis showed the enrolment of transcriptional factor Meis1 in this process. RQ-PCR experiments showed increased JAK2 expression in patients with the JAK2V617F mutation, with a significant difference between essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF) patients. SNP rs12343867 showed no statistically significant influence on the expression of JAK2 gene in MNP patients.
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Affiliation(s)
- Vesna Spasovski
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia
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Bastie JN, Aucagne R, Droin N, Solary E, Delva L. Heterogeneity of molecular markers in chronic myelomonocytic leukemia: a disease associated with several gene alterations. Cell Mol Life Sci 2012; 69:2853-61. [PMID: 22415325 PMCID: PMC11114957 DOI: 10.1007/s00018-012-0956-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 02/29/2012] [Accepted: 03/01/2012] [Indexed: 12/21/2022]
Abstract
The relatively homogenous clinical features and poor prognosis of chronic myelomonocytic leukemia (CMML) are associated with a molecular heterogeneity, with various mutations impacting several convergent pathways. Due to the restricted understanding of the mechanism involved in leukemogenesis, CMML still appears as a diagnostic and therapeutic undertaking, and poor prognosis of leukemia. Contrary to chronic myelogenous leukemia, BCR-ABL1-positive, cytogenetic, and molecular abnormalities of CMML are not specific and not pathognomonic, confirming the different levels of heterogeneity of this disease. Various mutations can be associated with a common phenotype not distinct at the clinical level, further demonstrating that molecular probings are needed for choosing individual targeted therapies.
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Affiliation(s)
- Jean-Noël Bastie
- Faculté de Médecine, Inserm UMR 866, Université de Bourgogne, 7 bd Jeanne d’Arc, 21000 Dijon, France
- Service d’Hématologie Clinique, Centre Hospitalo-Universitaire, 21000 Dijon, France
| | - Romain Aucagne
- Faculté de Médecine, Inserm UMR 866, Université de Bourgogne, 7 bd Jeanne d’Arc, 21000 Dijon, France
- Laboratoire de Génétique Moléculaire des Cellules Souches, Institut de Recherche en Immunologie et en Cancérologie, Université de Montréal, Montréal, QC H3C 3J7 Canada
| | - Nathalie Droin
- Inserm UMR 1009, IRCIV, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - Eric Solary
- Inserm UMR 1009, IRCIV, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - Laurent Delva
- Faculté de Médecine, Inserm UMR 866, Université de Bourgogne, 7 bd Jeanne d’Arc, 21000 Dijon, France
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Abstract
Abstract
Myeloproliferative neoplasms (MPNs) are clonal disorders characterized by excessive production of mature blood cells. In the majority of classic MPN—polycythemia vera, essential thrombocythemia, and primitive myelofibrosis—driver oncogenic mutations affecting Janus kinase 2 (JAK2) or MPL lead to constitutive activation of cytokine-regulated intracellular signaling pathways. LNK, c-CBL, or SOCSs (all negative regulators of signaling pathways), although infrequently targeted, may either drive the disease or synergize with JAK2 and MPL mutations. IZF1 deletions or TP53 mutations are mainly found at transformation phases and are present at greater frequency than in de novo acute myeloid leukemias. Loss-of-function mutations in 3 genes involved in epigenetic regulation, TET2, ASXL1, and EZH2, may be early events preceding JAK2V617F but may also occur late during disease progression. They are more frequently observed in PMF than PV and ET and are also present in other types of malignant myeloid diseases. A likely hypothesis is that they facilitate clonal selection, allowing the dominance of the JAK2V617F subclone during the chronic phase and, together with cooperating mutations, promote blast crisis. Their precise roles in hematopoiesis and in the pathogenesis of MPN, as well as their prognostic impact and potential as a therapeutic target, are currently under investigation.
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Ioannidis S, Lamb ML, Wang T, Almeida L, Block MH, Davies AM, Peng B, Su M, Zhang HJ, Hoffmann E, Rivard C, Green I, Howard T, Pollard H, Read J, Alimzhanov M, Bebernitz G, Bell K, Ye M, Huszar D, Zinda M. Discovery of 5-chloro-N2-[(1S)-1-(5-fluoropyrimidin-2-yl)ethyl]-N4-(5-methyl-1H-pyrazol-3-yl)pyrimidine-2,4-diamine (AZD1480) as a novel inhibitor of the Jak/Stat pathway. J Med Chem 2010; 54:262-76. [PMID: 21138246 DOI: 10.1021/jm1011319] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The myeloproliferative neoplasms, polycythemia vera, essential thrombocythemia, and idiopathic myelofibrosis are a heterogeneous but related group of hematological malignancies characterized by clonal expansion of one or more myeloid lineages. The discovery of the Jak2 V617F gain of function mutation highlighted Jak2 as a potential therapeutic target in the MPNs. Herein, we disclose the discovery of a series of pyrazol-3-yl pyrimidin-4-amines and the identification of 9e (AZD1480) as a potent Jak2 inhibitor. 9e inhibits signaling and proliferation of Jak2 V617F cell lines in vitro, demonstrates in vivo efficacy in a TEL-Jak2 model, has excellent physical properties and preclinical pharmacokinetics, and is currently being evaluated in Phase I clinical trials.
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Affiliation(s)
- Stephanos Ioannidis
- Department of Cancer Chemistry, AstraZeneca R&D, Boston, Massachusetts, United States.
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