CALR, JAK2, and MPL mutation profiles in patients with four different subtypes of myeloproliferative neoplasms: primary myelofibrosis, essential thrombocythemia, polycythemia vera, and myeloproliferative neoplasm, unclassifiable

Am J Clin Pathol. 2015 May;143(5):635-44. doi: 10.1309/AJCPUAAC16LIWZMM.

Abstract

Objectives: We investigated mutation profiles of CALR, JAK2, and MPL in 199 Korean patients with myeloproliferative neoplasms (MPNs).

Methods: In total, 199 patients with MPN (54 primary myelofibrosis [PMF], 79 essential thrombocythemia [ET], 58 polycythemia vera [PV], and eight MPN-unclassifiable [MPN-U]) and 4 patients with acute panmyelosis with myelofibrosis (APMF) were retrospectively subjected to Sanger sequencing for CALR, JAK2, and MPL.

Results: The overall frequency of CALR mutations was 12.6% (type 1 mutation, 16 patients; type 2 mutation, nine patients): most frequent in MPN-U (37.5%), followed by ET (17.7%) and PMF (14.8%). CALR mutations were not found in PV or APMF. CALR and JAK2 or MPL mutations were mutually exclusive. In PMF, the CALR mutations were associated with lower levels of leukocytes, lower bone marrow cellularity, and higher number of megakaryocytes. Patients with CALR-mutated ET more frequently progressed to the accelerated or blast phases compared with patients with JAK2 mutations. CALR mutations were frequently observed in the JAK2-negative MPNs, most frequently in MPN-U.

Conclusions: The prognostic significance of CALR mutations likely differs among the MPN subtypes.

Keywords: Calreticulin; JAK2; Myeloproliferative neoplasms; Somatic mutation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Calreticulin / genetics*
  • Child
  • Education, Medical, Continuing
  • Female
  • Humans
  • Janus Kinase 2 / genetics*
  • Male
  • Middle Aged
  • Mutation
  • Myeloproliferative Disorders / genetics*
  • Polycythemia Vera / genetics*
  • Primary Myelofibrosis / genetics*
  • Prognosis
  • Receptors, Thrombopoietin / genetics*
  • Republic of Korea
  • Survival Analysis
  • Thrombocythemia, Essential / genetics*
  • Young Adult

Substances

  • CALR protein, human
  • Calreticulin
  • Receptors, Thrombopoietin
  • MPL protein, human
  • JAK2 protein, human
  • Janus Kinase 2