Yonal-Hindilerden Ipek, Daglar-Aday Aynur, Akadam-Teker Basak, Yilmaz Ceylan, Nalcaci Meliha, Yavuz Akif Selim, Sargin Deniz
Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey.
J Clin Med Res. 2015 Mar;7(3):161-70. doi: 10.14740/jocmr2047w. Epub 2014 Dec 29.
Studies regarding the impact of JAK2V617F allele burden on phenotypic properties and clinical course in Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs) have reported variable results. We aimed to analyze the association of mutated JAK2V617F allele burden with laboratory characteristics and clinical phenotype in Turkish patients (107 essential thrombocythemia (ET) and 77 primary myelofibrosis (PMF)).
Peripheral blood samples of 184 patients with Ph-negative MPNs were analyzed for JAK2V617F allele status and burden. JAK2 MutaScreen assay (Ipsogen, Luminy Biotech, Marseille, France) was used to detect the JAK2V617F status and quantitative JAK2V617F allele burdens in genomic DNA using TaqMan allelic discrimination.
Frequency of JAK2V617F-positive patients with high mutation load (allele burden > 50%) was higher in PMF compared to ET (23.4% and 4.7%, respectively; P = 0.001). We found significant association between ET patients with high JAK2V617F allele burden and lower hemoglobin (Hgb) and hematocrit (Hct), higher LDH levels and more prevalent massive splenomegaly (P = 0.001, P = 0.001, P = 0.012 and P = 0.015, respectively). ET patients with high mutation load displayed higher prevalence of bleeding compared to low mutation load and wild-type mutational status (P = 0.003). Rate of DVT was significantly higher in ET patients with mutant allele burden in upper half compared to lower half and wild-type (P = 0.029). We observed significant association between PMF patients with high JAK2V617F allele burden and higher Hgb, Hct levels and leukocyte counts (P = 0.003, P = 0.021 and P = 0.001, respectively).
Our study demonstrated JAK2V617F allele burden correlates with clinical features in ET and PMF. We conclude quantification of JAK2V617F mutation contributes to the workup of Ph-negative MPNs.
关于JAK2V617F等位基因负荷对费城染色体阴性骨髓增殖性肿瘤(Ph阴性MPN)的表型特征和临床病程影响的研究报告结果不一。我们旨在分析土耳其患者(107例原发性血小板增多症(ET)和77例原发性骨髓纤维化(PMF))中JAK2V617F突变等位基因负荷与实验室特征及临床表型之间的关联。
对184例Ph阴性MPN患者的外周血样本进行JAK2V617F等位基因状态和负荷分析。采用JAK2 MutaScreen检测法(Ipsogen,法国马赛卢米尼生物技术公司)检测JAK2V617F状态,并使用TaqMan等位基因鉴别法对基因组DNA中的JAK2V617F等位基因负荷进行定量分析。
与ET患者相比,PMF患者中JAK2V617F阳性且突变负荷高(等位基因负荷>50%)的患者频率更高(分别为23.4%和4.7%;P = 0.001)。我们发现JAK2V617F等位基因负荷高的ET患者与较低的血红蛋白(Hgb)和血细胞比容(Hct)、较高的乳酸脱氢酶(LDH)水平以及更普遍的巨脾症之间存在显著关联(分别为P = 0.001、P = 0.001、P = 0.012和P = 0.015)。与低突变负荷和野生型突变状态的ET患者相比,高突变负荷的ET患者出血发生率更高(P = 0.003)。与突变等位基因负荷位于下半部分及野生型的ET患者相比,突变等位基因负荷位于上半部分的ET患者深静脉血栓形成(DVT)发生率显著更高(P = 0.029)。我们观察到JAK2V617F等位基因负荷高的PMF患者与较高的Hgb、Hct水平及白细胞计数之间存在显著关联(分别为P = 0.003、P = 0.021和P = 0.001)。
我们的研究表明JAK2V617F等位基因负荷与ET和PMF的临床特征相关。我们得出结论,JAK2V617F突变的定量分析有助于Ph阴性MPN的检查。