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Park, Kim, Lee, Ha, Ryoo, Jeon, Kim, Ham, Suh, and Kim: Frequency and Clinicohematologic Characteristics of MPL W515 Mutations in Patients with Myeloproliferative Neoplasms

Abstract

Background

Recently, myeloproliferative leukemia (MPL) W515 mutations have been reported to be molecular markers for myeloproliferative neoplasms (MPNs). We studied the association between MPL W515 mutations and the clinico-hematological features of patients with MPNs.

Methods

Our study included 154 consecutive patients diagnosed with MPNs (31 had polycythemia vera [PV]; 106, essential thrombocythemia [ET]; and 17, primary myelofibrosis [PMF]). MPL W515 mutations were detected by real-time PCR and direct sequencing methods.

Results

The MPL W515L mutation was found in 4 patients and the MPL W515A mutation was detected in 1 patient. These 5 patients were diagnosed with JAK2 V617F-negative ET, and they accounted for 12.5% of patients with JAK2 V617F-negative ET. The patients with MPL W515-positive ET showed significantly lower hemoglobin levels and WBC counts than did patients with MPL W515-negative ET or JAK2 V617F-positive ET.

Conclusions

MPL W515 mutation is a useful diagnostic marker for JAK2 V617F-negative MPNs and it is associated with specific hematologic characteristics such as lower hemoglobin levels and WBC counts.

Figures and Tables

Fig. 1

Electropherograms of normal control (upper), MPL W515L mutation (middle), and MPL W515A mutation (lower).

lmo-5-1-g001
Table 1

Comparison of laboratory and clinical features between patientswith MPL W515 positive ET and MPL W515 negative ET

lmo-5-1-i001
MPL W515
positive
MPL W515 negative P value
JAK2 V617F
positive
JAK2 V617F
negative
Total MPL W515
positive vs. MPL
W515 negative
MPL W515
positive vs. JAK2
V617F positive
MPL W515
positive vs. JAK2
V617F negative
Number (%) 5 (4.7) 66 (62.3) 35 (33.0) 101 (95.3)
Men:Women 4:1 33:33 15:20 48:53 0.201 0.359 0.172
Median age, yr (range) 69 (62-72) 68 (22-86) 63 (27-84) 67 (22-86) 0.764 0.957 0.358
Median WBC count, 109/L (range) 8.1 (4.4-11.4) 13.3 (5.2-56.9) 9.9 (1.6-64.4) 11.7 (1.6-64.4) 0.015 0.002 0.197
Median Hb, g/dL (range) 11.1 (6.9-12.8) 13.9 (6.7-17.6) 12.9 (8.6-16.5) 13.5 (6.7-17.6) 0.019 0.010 0.078
Median platelet, 109/L (range) 1,187.0
(823.0-1527.0)
1,038.0
(579.0-1917.0)
1,086.0
(370.0-2539.0)
1,071.0
(370.0-2539.0)
0.521 0.436 0.751
Organomegaly (%) 2/2 (100) 21/30 (70) 6/11 (54.5) 27/41 (65.9) 1.000 1.000 0.487
Thromboembolic event (%) 2/5 (40) 18/58 (31) 6/32 (18.8) 24/90 (26.7) 0.612 0.649 0.292
Median fibrosis grade (range) 0 (0-3) 1 (0-3) 1 (0-3) 1 (0-3) 0.502 0.45 0.682
Abnormal karyotype (%) 0/5 (0) 2/52 (3.8) 4/30 (13.3) 6/82 (7.3) 1.000 1.000 1.000

Abrreviations: MPL, myeloproliferative leukemia; JAK2, Janus kinase 2; WBC, white blood cell; Hb, hemoglobin.

Notes

This article is available from http://www.labmedonline.org

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