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JAK2 V617F和CALR突变在BCR-ABL阴性原发性血小板增多症患者中的临床和血液学相关性

Clinical and hematological relevance of JAK2 V617F and CALR mutations in BCR-ABL-negative ET patients.

作者信息

Limsuwanachot N, Rerkamnuaychoke B, Chuncharunee S, Pauwilai T, Singdong R, Rujirachaivej P, Chareonsirisuthigul T, Siriboonpiputtana T

机构信息

a Human Genetics Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital , Mahidol University , Bangkok , Thailand.

b Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital , Mahidol University , Bangkok , Thailand.

出版信息

Hematology. 2017 Dec;22(10):599-606. doi: 10.1080/10245332.2017.1312736. Epub 2017 Apr 13.

Abstract

BACKGROUND

Classical BCR-ABL1-negative myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia (ET), and primary myelofibrosis frequently harbor JAK2, MPL, and CALR somatic mutations.

METHODS

AS-PCR for JAK2 V617F, pyrosequencing for MPL W515L/K, and PCR-fragment analysis for CALR exon 9 mutations were established to analyze genomic DNA isolated from peripheral blood samples of 58 newly diagnosed ET patients in Thailand.

RESULTS

JAK2 V617F was detected in 41 patients (71%) and CALR exon 9 mutation was positive in eight patients (14%), whereas no mutation of MPL W515L/K was observed in this study. Patients with CALR mutation were older (p = 0.023) and exhibited lower number of platelet count (p = 0.041) than patients without CALR mutation. Two previously known CALR mutation types were identified in this study (six patients with CALR-type 1 and two patients with CALR-type 2). Additionally, no co-existence of JAK2 V617F and CALR mutations was identified in this work.

CONCLUSION

We reported the frequency of JAK2 V617F, MPL W515L/K, and CALR mutations in Thai patients with ET. Clinical and hematological phenotypes of patients were associated with JAK2 and CALR mutation statuses. The combination of laboratory testing for the detection of JAK2, CALR, and MPL mutations is necessary to improve the diagnosis and classification of BCR-ABL1-negative MPN.

摘要

背景

经典的BCR-ABL1阴性骨髓增殖性肿瘤(MPN),包括真性红细胞增多症、原发性血小板增多症(ET)和原发性骨髓纤维化,常常存在JAK2、MPL和CALR体细胞突变。

方法

建立针对JAK2 V617F的等位基因特异性PCR(AS-PCR)、针对MPL W515L/K的焦磷酸测序以及针对CALR第9外显子突变的PCR片段分析,以分析从泰国58例新诊断的ET患者外周血样本中分离的基因组DNA。

结果

41例患者(71%)检测到JAK2 V617F,8例患者(14%)CALR第9外显子突变呈阳性,而本研究中未观察到MPL W515L/K突变。与无CALR突变的患者相比,CALR突变患者年龄更大(p = 0.023)且血小板计数更低(p = 0.041)。本研究中鉴定出两种先前已知的CALR突变类型(6例CALR-1型患者和2例CALR-2型患者)。此外,本研究未发现JAK2 V617F和CALR突变共存的情况。

结论

我们报道了泰国ET患者中JAK2 V617F、MPL W515L/K和CALR突变的频率。患者的临床和血液学表型与JAK2和CALR突变状态相关。联合检测JAK2、CALR和MPL突变的实验室检测对于改善BCR-ABL1阴性MPN的诊断和分类是必要的。

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