JAK2V617F monitoring in polycythemia vera and essential thrombocythemia: clinical usefulness for predicting myelofibrotic transformation and thrombotic events.
The JAK2V617F allele burden has been identified as a risk factor for vascular events and myelofibrotic transformation in polycythemia vera (PV) and essential thrombocythemia (ET). However, all previous studies have evaluated a single time point JAK2V617F measurement. Therefore, the frequency and the clinical significance of changes in the JAK2V617F mutant load occurring during the disease evolution remain unknown. In the present study, JAK2V617F monitoring was performed during the follow-up of 347 patients (PV = 163, ET = 184). According to their JAK2V617F evolutionary patterns, patients were stratified as stable < 50% (n = 261), stable ≥50% (n = 52), progressive increase (n = 24) and unexplained decrease (n = 10). After a 2,453 person-years follow-up, a total of 59 thrombotic events, 16 major hemorrhages, and 27 cases of myelofibrotic transformations were registered. At multivariate analyses, patients with a persistently high (≥50%) or unsteady JAK2V617F load during follow-up had an increased risk of myelofibrotic transformation (Incidence rate ratio [IRR]: 20.7, 95% CI: 6.5-65.4; P < 0.001) and a trend for a higher incidence of thrombosis (IRR: 1.7, 1-3.3; P = 0.05) than patients with a stable allele burden below 50%. In conclusion, JAK2V617F monitoring could be useful in patients with PV and ET for predicting disease's complications, especially myelofibrotic transformation.
Hematology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona.
Alberto
A
Alvarez-Larrán
Beatriz
B
Bellosillo
Arturo
A
Pereira
Ana
A
Kerguelen
Juan Carlos
JC
Hernández-Boluda
Luz
L
Martínez-Avilés
Concepción
C
Fernández-Rodríguez
Montse
M
Gómez
Luis
L
Lombardía
Anna
A
Angona
Agueda
A
Ancochea
Alicia
A
Senín
Raquel
R
Longarón
Blanca
B
Navarro
María
M
Collado
Carlos
C
Besses
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D005260:Female; D006801:Humans; D015994:Incidence; D053614:Janus Kinase 2 / Q000097:blood* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000097:blood / Q000201:enzymology* / Q000235:genetics; D055728:Primary Myelofibrosis / Q000097:blood / Q000201:enzymology* / Q000235:genetics; D016019:Survival Analysis; D013920:Thrombocythemia, Essential / Q000097:blood / Q000201:enzymology* / Q000235:genetics; D013927:Thrombosis / Q000097:blood / Q000201:enzymology* / Q000235:genetics; D055815:Young Adult
C507924:JAK2 protein, human; D053614:Janus Kinase 2