Easwar Arti, Siddon Alexa J
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
Department of Pathology, Yale School of Medicine, New Haven, CT 06510, USA.
Life (Basel). 2021 Oct 30;11(11):1158. doi: 10.3390/life11111158.
Chronic myeloproliferative neoplasms (MPNs) are hematopoietic stem cell neoplasms with driver events including the translocation leading to a diagnosis of chronic myeloid leukemia (CML), or somatic mutations in , , or MPL resulting in Philadelphia-chromosome-negative MPNs with constitutive activation of the JAK-STAT signaling pathway. In the Philadelphia-chromosome-negative MPNs, modern sequencing panels have identified a vast molecular landscape including additional mutations in genes involved in splicing, signal transduction, DNA methylation, and chromatin modification such as , , , and . These additional mutations often influence prognosis in MPNs and therefore are increasingly important for risk stratification. This review focuses on the molecular alterations within the WHO classification of MPNs and laboratory testing used for diagnosis.
慢性骨髓增殖性肿瘤(MPN)是造血干细胞肿瘤,其驱动事件包括导致慢性髓性白血病(CML)诊断的易位,或JAK、STAT或MPL中的体细胞突变,导致JAK-STAT信号通路组成性激活的费城染色体阴性MPN。在费城染色体阴性MPN中,现代测序技术已发现了广阔的分子图景,包括参与剪接、信号转导、DNA甲基化和染色质修饰的基因(如SF3B1、SRSF2、EZH2和IDH1)中的其他突变。这些额外的突变常常影响MPN的预后,因此对风险分层越来越重要。本综述重点关注MPN的世界卫生组织分类中的分子改变以及用于诊断的实验室检测。