Jekarl Dong Wook, Han Sang Bong, Kim Myungshin, Lim Jihyang, Oh Eun-Jee, Kim Yonggoo, Kim Hee-Je, Min Woo-Sung, Han Kyungja
Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Hematol. 2010 Mar;45(1):46-50. doi: 10.5045/kjh.2010.45.1.46. Epub 2010 Mar 31.
The JAK2 V617F mutation has been noted in the cases of polycythemia vera, essential thrombocythemia, and primary myelofibrosis patients. This mutation occurs less frequently in acute myeloid leukemia (AML) and other hematologic diseases, such as myelodysplastic syndrome (MDS); myelodysplatic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U); and refractory anemia with ring sideroblasts with thrombocytosis (RARS-T).
Patients diagnosed with hematologic diseases other than MPN who visited Seoul St Mary's Hospital from January 2007 to February 2010 were selected. A total of 43 patients were enrolled in this study: 12 MDS, 9 MDS/MPN-U, 7 RARS-T, and 15 AML patients. The diseases were diagnosed according to the 2008 WHO classification criteria. Data obtained from JAK2 V617F mutation analysis and cytogenetic study as well as complete blood count and clinical data were analyzed.
Of the 43 patients, 6 (13.9%) harbored the JAK2 V617F mutation. The incidence of the JAK2 V617F mutation in each patient group was as follows: 8.3% (1/12), MDS; 22.2% (2/9), MDS/MPN-U; 14.3% (1/7), RARS-T; and 13.3%, (2/15) AML. The platelet count was higher than 450×10(9)/L in 3 of the 6 patients (50%) harboring the JAK2 V617F mutation, and it was in the normal range in the remaining 3 patients. Among the 6 patients, 1 MDS and 1 MDS/MPN-U patients had the 46,XX,del(20)(q11.2) karyotype.
The JAK2 V617F mutation is associated with an increased platelet count in MDS, MDS/MPN-U, RARS-T, and AML patients. Cytogenetic abnormalities of del(20)(q11.2) occurred in 1/3 of patients with the JAK2 V617F mutation but further studies are required to confirm this association.
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患者中已发现JAK2 V617F突变。这种突变在急性髓系白血病(AML)和其他血液系统疾病,如骨髓增生异常综合征(MDS)、无法分类的骨髓增生异常综合征/骨髓增殖性肿瘤(MDS/MPN-U)以及伴有血小板增多的环形铁粒幼细胞难治性贫血(RARS-T)中发生频率较低。
选取2007年1月至2010年2月期间就诊于首尔圣母医院、诊断为除MPN以外血液系统疾病的患者。本研究共纳入43例患者:12例MDS、9例MDS/MPN-U、7例RARS-T和15例AML患者。疾病根据2008年WHO分类标准进行诊断。对JAK2 V617F突变分析和细胞遗传学研究以及全血细胞计数和临床数据所获得的数据进行分析。
43例患者中,6例(13.9%)携带JAK2 V617F突变。各患者组中JAK2 V617F突变的发生率如下:MDS为8.3%(1/12);MDS/MPN-U为22.2%(2/9);RARS-T为14.3%(1/7);AML为13.3%(2/15)。6例携带JAK2 V617F突变的患者中有3例(50%)血小板计数高于450×10⁹/L,其余3例患者血小板计数在正常范围内。6例患者中,1例MDS和1例MDS/MPN-U患者具有46,XX,del(20)(q11.2)核型。
JAK2 V617F突变与MDS、MDS/MPN-U、RARS-T和AML患者血小板计数升高有关。del(20)(q11.2)的细胞遗传学异常发生在1/3携带JAK2 V617F突变的患者中,但需要进一步研究来证实这种关联。