Lieu C-H, Wu H-S, Hon Y-C, Tsai W-H, Yang C-F, Wang C-C, Lin Y-C, Shih C-H, Hsu H-C
Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang-Ming University, Taiwan.
Intern Med J. 2008 Jun;38(6):422-6. doi: 10.1111/j.1445-5994.2007.01589.x. Epub 2008 Mar 7.
The Janus kinase-2 (JAK-2) V617F mutation has been recently reported in patients with myeloproliferative disorders (MPD), which is believed to underlie growth factor hypersensitivity displayed by haematopoietic progenitors in these disorders. However, its frequency has been rarely determined in Taiwanese patients.
The frequency of JAK2-V617F mutation in patients with polycythaemia vera, essential thrombocythaemia and idiopathic myelofibrosis (IMF) was determined in the DNA from the peripheral blood leucocytes of 108 patients by genomic polymerase chain reaction and restriction enzyme-based assay.
The JAK2-V617F mutation could be detected in 28 of 33 polycythaemia vera patients (85%), 29 of 49 essential thrombocythaemia patients (59%) and 2 of 6 IMF patients (33%), but was not detected in 11 patients with myelodysplastic syndrome or another 10 with other haematological diseases. The presence of the JAK2 mutation was associated with specific MPD disease subtypes (P = 0.007), longer disease duration (P = 0.005), splenomegaly (P = 0.019), a higher white blood cell count (P = 0.002) and a higher haemoglobin level (P = 0.036). However, the overall risk of thrombosis or bleeding was not affected by the presence of the JAK2 mutation (32 vs 17%; P = 0.22).
The JAK2-V617F mutation can be frequently detected in the Taiwanese patients with MPD disorders and therefore should be incorporated into the initial evaluation of patients suspected of MPD.
近期有报道称,骨髓增殖性疾病(MPD)患者存在Janus激酶2(JAK-2)V617F突变,该突变被认为是这些疾病中造血祖细胞生长因子超敏反应的基础。然而,台湾患者中该突变的频率鲜有测定。
采用基因组聚合酶链反应和基于限制性内切酶的检测方法,对108例患者外周血白细胞DNA中真性红细胞增多症、原发性血小板增多症和原发性骨髓纤维化(IMF)患者的JAK2-V617F突变频率进行测定。
33例真性红细胞增多症患者中有28例(85%)可检测到JAK2-V617F突变,49例原发性血小板增多症患者中有29例(59%),6例IMF患者中有2例(33%),但11例骨髓增生异常综合征患者和另外10例其他血液病患者中未检测到该突变。JAK2突变的存在与特定的MPD疾病亚型相关(P = 0.007),病程较长(P = 0.005),脾肿大(P = 0.019),白细胞计数较高(P = 0.002)和血红蛋白水平较高(P = 0.036)。然而,JAK2突变的存在并未影响血栓形成或出血的总体风险(32%对17%;P = 0.22)。
台湾MPD疾病患者中可频繁检测到JAK2-V617F突变,因此应将其纳入疑似MPD患者的初始评估中。