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Syeed N. JAK2 and Beyond: Mutational Study of JAK2V617 in Myeloproliferative Disorders and Haematological Malignancies in Kashmiri population. Asian Pac J Cancer Prev 2019; 20:3611-3615. [PMID: 31870101 PMCID: PMC7173381 DOI: 10.31557/apjcp.2019.20.12.3611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Janus Tyrosine Kinase-2 (JAK2 V617F), a novel point mutation affecting the MPD'S is a somatic gain-of-function mutation. It alters a highly conserved amino acid valine in the negative regulatory JH2 domain to phenylalanine predicted to dysregulate kinase activity. AIM To evaluate the prevalence and clinical significance of JAK2 V617F mutation in various MPD's as well as in hematological malignancies. SUBJECTS AND METHODS JAK2 mutation was assessed in 90 patients with myeloproliferative disorders and 47 leukemic patients. In addition, peripheral blood samples from 90 healthy donors were also collected as control. We used a highly sensitive Allele-Specific polymerase chain reaction (AS-PCR) for the detection and confirmed the mutation further by direct sequencing. RESULTS Our results showed significant differences between various disorders with respect to either the proportion of positivity or that of mutant alleles. JAK2-V617F was detected in 67/90 MPD patients and 02/17 for AML,01/11 for ALL-L1,02/12 for ALL-L2 and 02/07 for CML and 90 healthy controls. CONCLUSION From the above findings it is evident that the JAK2 V617F mutation is widespread not only in MPD's but also in hematological malignancies, which might as well lead to the new classification of MPD'S. Our data also suggest that different genetic events may lead to JAK-STAT pathway activation in different malignancies.
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Affiliation(s)
- Nidda Syeed
- College of Applied Medical Sciences, Taibah University, Madinah Saudi Arabia.,Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, 190011, India
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Acute Lymphoblastic Leukemia with Hypereosinophilia in a Child: Case Report and Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061169. [PMID: 29867057 PMCID: PMC6025476 DOI: 10.3390/ijerph15061169] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/28/2018] [Accepted: 05/31/2018] [Indexed: 01/04/2023]
Abstract
Background: Hypereosinophilia in children can be primary or secondary. Numerous malignant diseases can cause hypereosinophilia, but it is seldom caused by acute lymphoblastic leukemia (ALL). In the event of protracted hypereosinophilia, it is extremely important to make a correct differential diagnosis. Case presentation: We present the case of an 11-year-old boy of Moroccan origin with ALL with hypereosinophilic onset (eosinophils in peripheral blood, 10,000/µL) in the absence of other signs of neoplastic disease, and compare this case with 61 similar cases in the literature. Following hospital admission, the patient initially presented with headache-caused nocturnal awakenings, evening fever, and cough, and he also lost approximately 7 kg in weight in a month not associated with sweating or itching. We first performed bone marrow aspiration, which showed an increase in eosinophils without cellular morphological abnormalities, and bone marrow immunophenotyping showed that 4.5% of cells had a phenotype compatible with lymphoid blasts. A lumbar puncture was negative. Given the poor marrow involvement, it was necessary to repeat a new bone marrow aspiration two days later, which showed an increase in blasts to 14%. A concomitant bone marrow biopsy showed an infiltration of blasts typical of B-cell ALL equal to 20–30% with associated hypereosinophilia. Cytogenetic analysis showed an hyperdiploid karyotype: 53–55, XY, +X, add(1)(q21q25), +4, +9, +10, +14, +2, +1, +21/46, XY. Conclusions: ALL is one of the possible causes of persistent hypereosinophilia. In patients with ALL and hypereosinophilia, peripheral hypereosinophilia can precede the appearance of blasts. Due to the negative prognosis and the increased risk of complications in these patients, bone marrow aspiration and biopsy are recommended if common causes of secondary hypereosinophilia are excluded.
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Sahu KK, Malhotra P, Khadwal A, Sachdeva MS, Sharma P, Varma N, Varma SC. Hypereosinophilia in Acute Lymphoblastic Leukemia: Two Cases with Review of Literature. Indian J Hematol Blood Transfus 2015; 31:460-5. [PMID: 26306071 PMCID: PMC4542759 DOI: 10.1007/s12288-014-0436-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/10/2014] [Indexed: 01/22/2023] Open
Abstract
Eosinophilia is rare in acute leukemia at presentation. Discrete reports and case studies in recent years have created significant interest in the field of "Acute leukemia with eosinophilia". We herein present two cases of eosinophilia in association with acute lymphoblastic leukemia with brief review of literature in this field. First case is about 21-year-old female who presented with mediastinal mass along with leukocytosis and hypereosinophilia. On evaluation, she was found to have T cell acute lymphoblastic leukemia. After ruling out benign causes of eosinophilia, she was treated with modified BFM-90 protocol. Her eosinophilia resolved after 4 weeks of induction therapy. Second case is about 32-year-old male who was diagnosed as a case of mixed phenotype leukemia (B cell/myeloid type) along with severe eosinophilia. His hypereosinophilia finally resolved by week 16 of modified BFM-90 protocol. Diagnosing ALL is challenging when eosinophilia is the initial presentation. These two cases emphasize on the importance of considering ALL amongst one of the etiological causes of eosinophilia as delay in diagnosis endangers patient's life at risk. Also eosinophilia per se is an independent poor risk factor, hence prompt diagnosis and early treatment is the key in all such cases.
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Affiliation(s)
- Kamal Kant Sahu
- />Department of Clinical Hematology, Internal Medicine, PGIMER, Chandigarh, India
| | - Pankaj Malhotra
- />Department of Clinical Hematology, Internal Medicine, PGIMER, Chandigarh, India
| | - Alka Khadwal
- />Department of Clinical Hematology, Internal Medicine, PGIMER, Chandigarh, India
| | | | | | - Neelam Varma
- />Department of Hepatopathology, PGIMER, Chandigarh, India
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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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A practical strategy of monitoring minimal residue disease and intervention for central nervous system relapse of childhood acute lymphoblastic leukemia: a single Chinese center's experience. J Pediatr Hematol Oncol 2013; 35:388-93. [PMID: 23787730 DOI: 10.1097/mph.0b013e31829084eb] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate monitoring minimal residual disease (MRD) using cerebral spinal fluid for predicting central nervous system leukemia (CNSL) and treatment. OBSERVATIONS There is no survival difference between enhanced triple intrathecal therapy (ETIT) and cranial radiation for CNSL patients with positive morphology and MRD. Positive MRD correlated with CNSL, whereas negative MRD indicated a lower chance of CNSL recurrence. Altogether 79 cerebral spinal fluid specimens indicating negative morphology but positive MRD were given either ETIT or conventional triple intrathecal therapy. The ETIT group indicated lower relapse. CONCLUSION Flow cytometry is sensitive to predict CNSL and ETIT is a potent intervention.
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Montgomery ND, Dunphy CH, Mooberry M, Laramore A, Foster MC, Park SI, Fedoriw YD. Diagnostic Complexities of Eosinophilia. Arch Pathol Lab Med 2013; 137:259-69. [DOI: 10.5858/arpa.2011-0597-ra] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.— The advent of molecular tools capable of subclassifying eosinophilia has changed the diagnostic and clinical approach to what was classically called hypereosinophilic syndrome.Objectives.— To review the etiologies of eosinophilia and to describe the current diagnostic approach to this abnormality.Data Sources.— Literature review.Conclusions.— Eosinophilia is a common, hematologic abnormality with diverse etiologies. The underlying causes can be broadly divided into reactive, clonal, and idiopathic. Classically, many cases of eosinophilia were grouped together into the umbrella category of hypereosinophilic syndrome, a clinical diagnosis of exclusion. In recent years, an improved mechanistic understanding of many eosinophilias has revolutionized the way these disorders are understood, diagnosed, and treated. As a result, specific diagnoses can now be assigned in many cases that were previously defined as hypereosinophilic syndrome. Most notably, chromosomal rearrangements, such as FIP1L1-PDGFRA fusions caused by internal deletions in chromosome 4, are now known to be associated with many chronic eosinophilic leukemias. When present, these specific molecular abnormalities predict response to directed therapies. Although an improved molecular understanding is revolutionizing the treatment of patients with rare causes of eosinophilia, it has also complicated the approach to evaluating and treating eosinophilia. Here, we review causes of eosinophilia and present a framework by which the practicing pathologist may approach this diagnostic dilemma. Finally, we consider recent cases as clinical examples of eosinophilia from a single institution, demonstrating the diversity of etiologies that must be considered.
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Affiliation(s)
- Nathan D. Montgomery
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
| | - Cherie H. Dunphy
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
| | - Micah Mooberry
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
| | - Andrew Laramore
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
| | - Matthew C. Foster
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
| | - Steven I. Park
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
| | - Yuri D. Fedoriw
- From the Departments of Pathology and Laboratory Medicine, Division of Hematopathology (Drs Montgomery, Dunphy, Laramore, and Fedoriw); and Medicine, Division of Hematology and Oncology (Drs Mooberry, Foster, and Park), University of North Carolina School of Medicine, Chapel Hill
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Abstract
Cerebrospinal fluid-acute leukemia (CSF-acute leukemia) is a frequent and serious complication in patients with acute leukemia. One of the major problems of this complication is the diagnosis process itself. CSF cytology is currently considered the gold standard for establishing the diagnosis, a technique which presents various processing limitations, seriously impacting the predictive values. In the last 11 years, studies of CSF flow cytometry analysis done in patients with acute leukemia have demonstrated superiority in comparison with CSF cytology. Although comparative studies between these two techniques have been reported since 2001, no new consensus or formal changes to the gold standard have been established for the CSF acute leukemia diagnosis. The evidence suggests that positive flow cytometry cases, considered as indeterminate cases, will behave like disease in the central nervous system (CNS). Nevertheless, we think there are some variables and considerations that must be first evaluated under research protocols before CNS relapse can be established with only one positive flow cytometry analysis in the setting of indeterminate CSF samples. This paper proposes a diagnostic algorithm and complementary strategies.
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Rezk S, Wheelock L, Fletcher JA, Oliveira AM, Keuker CP, Newburger PE, Xu B, Woda BA, Miron PM. Acute lymphocytic leukemia with eosinophilia and unusual karyotype. Leuk Lymphoma 2007; 47:1176-9. [PMID: 16840218 DOI: 10.1080/10428190500508710] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Quentmeier H, MacLeod RAF, Zaborski M, Drexler HG. JAK2 V617F tyrosine kinase mutation in cell lines derived from myeloproliferative disorders. Leukemia 2006; 20:471-6. [PMID: 16408098 DOI: 10.1038/sj.leu.2404081] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A mutation in the JH2 pseudokinase domain of the Janus kinase 2 gene (JAK2 V617F) has been described in chronic myeloproliferative disorders (MPD). We screened 79 acute myeloid leukemia (AML) cell lines and found five positive for JAK2 V617F (HEL, MB-02, MUTZ-8, SET-2, UKE-1), 4/5 with histories of MPD/MDS. While SET-2 expressed both mutant (mu) and wild-type (wt) JAK2, remaining positives carried homo-/hemizygous JAK2 mutations. Microsatellite analysis confirmed losses of heterozygosity (LOH) affecting the JAK2 region on chromosome 9p in MB-02, MUTZ-8 and UKE-1, but also in HEL, the only JAK2mu cell line lacking any reported MPD/MDS history. All five JAK2mu cell lines displayed cytogenetic hallmarks of MDS, namely losses of 5q or 7q, remarkably in 4/5 cases affecting both chromosomes. Our combined FISH and microsatellite analysis uncovered a novel mechanism to supplement mitotic recombination previously proposed to explain JAK2 LOH, namely chromosome deletion with/without selective JAK2mu amplification. Confirming the importance of the mutated JAK2 protein for growth and prevention of apoptosis, JAK2mu cell lines displayed higher sensitivities to JAK2 inhibition than JAK2wt cell lines. In summary, JAK2 V617F cell lines, derived from patients with history of MPD/MDS, represent novel research tools for elucidating the pathobiology of this JAK2 mutation.
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Affiliation(s)
- H Quentmeier
- DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany.
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Han X, Bueso-Ramos CE. Advances in the pathological diagnosis and biology of acute lymphoblastic leukemia. Ann Diagn Pathol 2005; 9:239-57. [PMID: 16084461 DOI: 10.1016/j.anndiagpath.2005.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
An accurate diagnosis of acute lymphocytic leukemia requires careful examination of the morphology, immunophenotype, genetic features, clinical characteristics, and molecular findings. This multiparametric approach should be used to achieve optimal evaluation of every suspected case of acute lymphocytic leukemia.
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Affiliation(s)
- Xin Han
- Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
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Jelinek J, Oki Y, Gharibyan V, Bueso-Ramos C, Prchal JT, Verstovsek S, Beran M, Estey E, Kantarjian HM, Issa JPJ. JAK2 mutation 1849G>T is rare in acute leukemias but can be found in CMML, Philadelphia chromosome-negative CML, and megakaryocytic leukemia. Blood 2005; 106:3370-3. [PMID: 16037387 PMCID: PMC1895065 DOI: 10.1182/blood-2005-05-1800] [Citation(s) in RCA: 289] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
An activating 1849G>T mutation of JAK2 (Janus kinase 2) tyrosine kinase was recently described in chronic myeloproliferative disorders (MPDs). Its role in other hematologic neoplasms is unclear. We developed a quantitative pyrosequencing assay and analyzed 374 samples of hematologic neoplasms. The mutation was frequent in polycythemia vera (PV) (86%) and myelofibrosis (95%) but less prevalent in acute myeloid leukemia (AML) with an antecedent PV or myelofibrosis (5 [36%] of 14 patients). JAK2 mutation was also detected in 3 (19%) of 16 patients with Philadelphia-chromosome (Ph)-negative chronic myelogenous leukemia (CML), 2 (18%) of 11 patients with megakaryocytic AML, 7 (13%) of 52 patients with chronic myelomonocytic leukemia, and 1 (1%) of 68 patients with myelodysplastic syndromes. No mutation was found in Ph(+)CML (99 patients), AML M0-M6 (28 patients), or acute lymphoblastic leukemia (20 patients). We conclude that the JAK2 1849G>T mutation is common in Ph(-) MPD but not critical for transformation to the acute phase of these diseases and that it is generally rare in aggressive leukemias.
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Affiliation(s)
- Jaroslav Jelinek
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA.
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Roy BC, Aoyagi T, Sarkar S, Nomura K, Kanda H, Iwaya K, Tachibana M, Kiyama R. Pathological characterization of Kank in renal cell carcinoma. Exp Mol Pathol 2005; 78:41-8. [PMID: 15596059 DOI: 10.1016/j.yexmp.2004.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2004] [Indexed: 10/26/2022]
Abstract
The Kank gene was found as a candidate tumor suppressor gene at 9p24 by loss-of-heterozygosity search in renal cell carcinoma (RCC) and seems to have a role in controlling the formation of the cytoskeleton through the polymerization of actin. Here, we characterized the Kank protein in renal tubular cells as well as other glandular cells in the colon, stomach, prostate, testis, pancreas, thyroid, uterus, submandibular gland, adrenal, duodenum, and esophagus, and specific cells such as hepatic, alveolar myocardial, and glial cells by using a monoclonal antibody against Kank. Loss of expression of Kank in one RCC sample was detected by immunohistochemical and Western blot analyses while expression of CDKN2A (p16/Ink4A) was retained in the sample. The expression of Kank in the cytoplasm and at the sites of membrane ruffling in HEK293 and VMRC-RCW cells and in a primary culture of renal tubular cells was also detected by fluorescence-based immunostaining.
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Affiliation(s)
- Badal Chandra Roy
- Institute for Biological Resources and Functions, National Institute of Advanced Industrial Science and Technology, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan
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