Brown Ryan, Jasiakiewicz Joanna, Greer Victoria, Hindley Andrew, McDowell Katie, Devlin Eadaoin, Clarke Kathryn, Buckley Frances, Crean Clare, McGimpsey Julie, Cuthbert Robert J G, Cunningham Nick, Arnold Claire, Finnegan Damian, Benson Gary, McMullin Mary Frances, Catherwood Mark A
Haematology, Belfast City Hospital, BHSCT, Belfast, Northern Ireland, UK.
Haematology Department, NHS Highland, Inverness, Scotland, UK.
Ir J Med Sci. 2024 Dec;193(6):2883-2888. doi: 10.1007/s11845-024-03776-5. Epub 2024 Aug 14.
Myeloproliferative neoplasms (MPNs) are a group of chronic disorders of the bone marrow characterised by the overproduction of clonal myeloid stem cells. The most common driver mutation found in MPNs is a point mutation on exon 14 of the JAK2 gene, JAK2. Various studies have suggested that measuring the variable allele frequency (VAF) of JAK2 may provide useful insight regarding diagnosis, treatment, risks and outcomes in MPN patients. In particular, JAK2 has been associated with increased risk of thrombotic events, a leading cause of mortality in MPNs.
The aim of this study was to determine if JAK2 VAF was associated with clinical outcomes in patients with MPN.
JAK2 VAF was determined by quantitative PCR (qPCR) in a cohort of 159 newly diagnosed MPN patients, and the association of JAK2 VAF and risk of thrombosis was examined in this cohort.
We observed a significantly higher JAK2 VAF in PV and PMF versus ET. A significant association was observed between JAK2 VAF and risk of thrombotic events. When patients were stratified by thrombotic events prior to and post diagnosis, an association with JAK2 VAF was only observed with post diagnosis thrombotic events. Of note, these associations were not observed when looking at each MPN subtype in isolation.
We have shown that a higher JAK2 VAF is associated with thrombotic events post MPN diagnosis. JAK2 VAF may therefore provide a valuable prognostic indicator for risk of thrombosis in MPNs.
骨髓增殖性肿瘤(MPNs)是一组骨髓慢性疾病,其特征为克隆性髓系干细胞过度增殖。MPNs中最常见的驱动突变是JAK2基因第14外显子上的点突变,即JAK2。多项研究表明,测量JAK2的可变等位基因频率(VAF)可能有助于深入了解MPN患者的诊断、治疗、风险和预后。特别是,JAK2与血栓形成事件风险增加有关,而血栓形成事件是MPNs患者死亡的主要原因。
本研究旨在确定JAK2 VAF是否与MPN患者的临床结局相关。
通过定量PCR(qPCR)测定159例新诊断的MPN患者队列中的JAK2 VAF,并在该队列中研究JAK2 VAF与血栓形成风险的相关性。
我们观察到真性红细胞增多症(PV)和原发性骨髓纤维化(PMF)患者的JAK2 VAF显著高于原发性血小板增多症(ET)患者。JAK2 VAF与血栓形成事件风险之间存在显著相关性。当根据诊断前后的血栓形成事件对患者进行分层时,仅在诊断后血栓形成事件中观察到与JAK2 VAF的相关性。值得注意的是,单独观察每种MPN亚型时未观察到这些相关性。
我们已经表明,较高的JAK2 VAF与MPN诊断后的血栓形成事件相关。因此,JAK2 VAF可能为MPNs患者的血栓形成风险提供有价值的预后指标。