Shams Seyyede Fatemeh, Ayatollahi Hossein, Sadeghian Mohammad Hadi, Afzalaghaee Monavar, Shakeri Sepideh, Yazdandoust Ehsan, Sheikhi Maryam, Amini Nafiseh, Bakhshi Samane, Bahrami Afsane
Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Dept. of Statistics and Epidemiology, Faculty of Health, MUMS, Mashhad, Iran.
Iran J Pathol. 2018 Fall;13(4):397-402. Epub 2018 Sep 25.
Janus kinase 2 (JAK2) and Myeloproliferative Leukemia (MPL) mutations are confirmatory indicators for Myeloproliferative Neoplasm (MPN). The current study was performed to determine the frequency of MPL mutation in MPN patients without JAK2 mutation, in order to assign MPL mutation frequency in North-East of Iran.
Total of 105 negative JAK2 cases including 5 Myeloproliferative Disorders (MPD), 15 Polycytemia Vera (PV) and 15 Essential Thrombocytosis (ET) who referred to Qaem Medical Center were assigned to this study. ARMS-PCR was carried out for measuring MPL mutations.
A significant difference was observed between MPL mutant and non-mutant groups from overview of MPL mutation (=0.00001). From the total studied population, 14.28% were ET cases and 4.71% of them had splenomegaly. About 66.66% had thrombocytosis and 33.33% of all the individuals had leukocytosis according to WHO criteria, and 4.76% of non-MPL mutant individuals had splenomegaly (=1).This mutation was reported in 4-6% of ET and PMF individuals. In this research, 4.76 % of studied individuals had MPL (W515L/K) mutation, which were diagnosed with ET.
Generally, the presence of JAK2 and MPL mutations are the most important criteria for MPN diagnosis. The obtained frequency of MPL mutation was similar to previous studies. Despite the high frequency of JAK2 and Philadelphia abnormality, MPL mutation was rare in myeloprolifrative disorders. Further studies are suggested to investigate its prognostic effects for these diseases.
Janus激酶2(JAK2)和骨髓增殖性白血病(MPL)突变是骨髓增殖性肿瘤(MPN)的确诊指标。本研究旨在确定无JAK2突变的MPN患者中MPL突变的频率,以明确伊朗东北部地区MPL突变的频率。
本研究纳入了105例JAK2检测阴性的患者,其中包括5例骨髓增殖性疾病(MPD)、15例真性红细胞增多症(PV)和15例原发性血小板增多症(ET),这些患者均转诊至卡姆医学中心。采用扩增阻滞突变系统聚合酶链反应(ARMS-PCR)检测MPL突变。
从MPL突变总体情况来看,MPL突变组与非突变组之间存在显著差异(=0.00001)。在所有研究对象中,14.28%为ET患者,其中4.71%有脾肿大。根据世界卫生组织标准,约66.66%的患者有血小板增多症,33.33%的患者有白细胞增多症,非MPL突变个体中有4.76%有脾肿大(=1)。在ET和原发性骨髓纤维化(PMF)个体中,该突变的报告发生率为4%-6%。在本研究中,4.76%的研究对象有MPL(W515L/K)突变,这些患者被诊断为ET。
一般来说,JAK2和MPL突变的存在是MPN诊断的最重要标准。获得的MPL突变频率与先前研究相似。尽管JAK2和费城染色体异常的频率较高,但MPL突变在骨髓增殖性疾病中较为罕见。建议进一步研究其对这些疾病的预后影响。