CALR vs JAK2 vs MPL-mutated or triple-negative myelofibrosis: clinical, cytogenetic and molecular comparisons

Calreticulin ( CALR ) mutations were recently described in JAK2 and MPL unmutated primary myelofibrosis (PMF) and essential thrombocythemia. In the current study, we compared the clinical, cytogenetic and molecular features of patients with PMF with or without CALR , JAK2 or MPL mutations. Among 254...

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Veröffentlicht in:Leukemia 2014-07, Vol.28 (7), p.1472-1477
Hauptverfasser: Tefferi, A, Lasho, T L, Finke, C M, Knudson, R A, Ketterling, R, Hanson, C H, Maffioli, M, Caramazza, D, Passamonti, F, Pardanani, A
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container_end_page 1477
container_issue 7
container_start_page 1472
container_title Leukemia
container_volume 28
creator Tefferi, A
Lasho, T L
Finke, C M
Knudson, R A
Ketterling, R
Hanson, C H
Maffioli, M
Caramazza, D
Passamonti, F
Pardanani, A
description Calreticulin ( CALR ) mutations were recently described in JAK2 and MPL unmutated primary myelofibrosis (PMF) and essential thrombocythemia. In the current study, we compared the clinical, cytogenetic and molecular features of patients with PMF with or without CALR , JAK2 or MPL mutations. Among 254 study patients, 147 (58%) harbored JAK2 , 63 (25%) CALR and 21 (8.3%) MPL mutations; 22 (8.7%) patients were negative for all three mutations, whereas one patient expressed both JAK2 and CALR mutations. Study patients were also screened for ASXL1 (31%), EZH2 (6%), IDH (4%), SRSF2 (12%), SF3B1 (7%) and U2AF1 (16%) mutations. In univariate analysis, CALR mutations were associated with younger age ( P
doi_str_mv 10.1038/leu.2014.3
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In the current study, we compared the clinical, cytogenetic and molecular features of patients with PMF with or without CALR , JAK2 or MPL mutations. Among 254 study patients, 147 (58%) harbored JAK2 , 63 (25%) CALR and 21 (8.3%) MPL mutations; 22 (8.7%) patients were negative for all three mutations, whereas one patient expressed both JAK2 and CALR mutations. Study patients were also screened for ASXL1 (31%), EZH2 (6%), IDH (4%), SRSF2 (12%), SF3B1 (7%) and U2AF1 (16%) mutations. In univariate analysis, CALR mutations were associated with younger age ( P &lt;0.0001), higher platelet count ( P &lt;0.0001) and lower DIPSS-plus score ( P =0.02). CALR -mutated patients were also less likely to be anemic, require transfusions or display leukocytosis. Spliceosome mutations were infrequent ( P =0.0001) in CALR -mutated patients, but no other molecular or cytogenetic associations were evident. In multivariable analysis, CALR mutations had a favorable impact on survival that was independent of both DIPSS-plus risk and ASXL1 mutation status ( P =0.001; HR 3.4 for triple-negative and 2.2 for JAK2 -mutated). Triple-negative patients also displayed inferior LFS ( P =0.003). 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In the current study, we compared the clinical, cytogenetic and molecular features of patients with PMF with or without CALR , JAK2 or MPL mutations. Among 254 study patients, 147 (58%) harbored JAK2 , 63 (25%) CALR and 21 (8.3%) MPL mutations; 22 (8.7%) patients were negative for all three mutations, whereas one patient expressed both JAK2 and CALR mutations. Study patients were also screened for ASXL1 (31%), EZH2 (6%), IDH (4%), SRSF2 (12%), SF3B1 (7%) and U2AF1 (16%) mutations. In univariate analysis, CALR mutations were associated with younger age ( P &lt;0.0001), higher platelet count ( P &lt;0.0001) and lower DIPSS-plus score ( P =0.02). CALR -mutated patients were also less likely to be anemic, require transfusions or display leukocytosis. Spliceosome mutations were infrequent ( P =0.0001) in CALR -mutated patients, but no other molecular or cytogenetic associations were evident. In multivariable analysis, CALR mutations had a favorable impact on survival that was independent of both DIPSS-plus risk and ASXL1 mutation status ( P =0.001; HR 3.4 for triple-negative and 2.2 for JAK2 -mutated). Triple-negative patients also displayed inferior LFS ( P =0.003). The current study identifies ‘CALR – ASXL1 + ’ and ‘triple-negative’ as high-risk molecular signatures in PMF.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>24402162</pmid><doi>10.1038/leu.2014.3</doi><tpages>6</tpages></addata></record>
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1476-5551
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subjects 631/208/2489/144
631/208/737
692/699/67/1990/2331
692/700/1750
Aged
Aged, 80 and over
Calreticulin
Calreticulin - genetics
Cancer
Cancer Research
Chromosome Aberrations
Critical Care Medicine
Cytogenetics
DNA Mutational Analysis
Female
Gene Expression
Gene mutations
Genetic aspects
Genetic research
Hematology
Hemoglobin
Humans
Identification and classification
Intensive
Internal Medicine
Janus kinase 2
Janus Kinase 2 - genetics
Leukemia
Leukocytes
Leukocytosis
Male
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Mutation
Myelofibrosis
Oncology
Oncology, Experimental
original-article
Patients
Primary Myelofibrosis - diagnosis
Primary Myelofibrosis - genetics
Primary Myelofibrosis - mortality
Prognosis
Proteins
Receptors, Thrombopoietin - genetics
title CALR vs JAK2 vs MPL-mutated or triple-negative myelofibrosis: clinical, cytogenetic and molecular comparisons
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