Wang Xiaoli, LeBlanc Amanda, Gruenstein Steven, Xu Mingjiang, Mascarenhas John, Panzera Brenda, Wisch Nathaniel, Parker Charles, Goldberg Judith D, Prchal Josef, Hoffman Ronald, Najfeld Vesna
Division of Hematology and Oncology, The Myeloproliferative Disorders Program, Tisch Cancer Institute, New York, NY, USA.
Exp Hematol. 2009 Oct;37(10):1194-200. doi: 10.1016/j.exphem.2009.07.003. Epub 2009 Jul 15.
JAK2V617F occurs in approximately 93% of patients with polycythemia vera and approximately 50% of patients with either primary myelofibrosis or essential thrombocythemia. Chromosomal abnormalities are detected in 50% of patients with primary myelofibrosis, 29% with polycythemia vera, and 8% to 10% with essential thrombocythemia. The relationship between the presence of such chromosomal abnormalities and the JAK2V617 allele burden, and the role that each of these genetic events play in the origins and progression of the myeloproliferative neoplasms (MPNs), remain unclear.
Individual hematopoietic colonies were assayed in vitro from the CD34(+) cells of six JAK2V617F-positive MPN patients with marker chromosomal abnormalities. Colonies were simultaneously analyzed for JAK2 genotype and chromosomal abnormalities.
Among the 248 colonies assayed from cultures containing 500 CD34(+) cells, chromosomal abnormalities were detected in 5% of colonies with wild-type JAK2, 32% of JAK2V617F heterozygous colonies and 56% of JAK2V617F homozygous colonies. Overall, 92% of chromosomally abnormal colonies were also JAK2V617F homozygous. Although 54 colonies contained wild-type JAK2 exclusively, 4 of these colonies were characterized by chromosomal abnormalities.
This study indicates that MPN hematopoietic progenitor cells do not necessarily always acquire genetic events in the same sequence. (Chromosomally abnormal progenitor cells are closely associated with JAK2V617F homozygosity; p=0.0001.). Chromosomal abnormalities such as +8, +9 can occasionally precede acquisition of JAK2V617F. These findings support the existence of earlier genetic events that precede JAK2V617F or cytogenetic abnormalities in MPN hematopoietic progenitor cells.
JAK2V617F存在于约93%的真性红细胞增多症患者以及约50%的原发性骨髓纤维化或原发性血小板增多症患者中。50%的原发性骨髓纤维化患者、29%的真性红细胞增多症患者以及8%至10%的原发性血小板增多症患者可检测到染色体异常。此类染色体异常的存在与JAK2V617等位基因负荷之间的关系,以及这些基因事件在骨髓增殖性肿瘤(MPN)的发生和发展中所起的作用仍不清楚。
从6例具有标记染色体异常的JAK2V617F阳性MPN患者的CD34(+)细胞中体外检测单个造血集落。同时对集落进行JAK2基因型和染色体异常分析。
在从含有500个CD34(+)细胞的培养物中检测的248个集落中,野生型JAK2的集落中有5%检测到染色体异常,JAK2V617F杂合集落中有32%,JAK2V617F纯合集落中有56%。总体而言,92%的染色体异常集落也是JAK2V617F纯合的。尽管有54个集落仅含有野生型JAK2,但其中4个集落具有染色体异常特征。
本研究表明,MPN造血祖细胞不一定总是按相同顺序获得基因事件。(染色体异常的祖细胞与JAK2V617F纯合性密切相关;p = 0.0001。)诸如+8、+9等染色体异常偶尔可先于JAK2V617F的获得。这些发现支持在MPN造血祖细胞中存在先于JAK2V617F或细胞遗传学异常的早期基因事件。