Characteristics and clinical correlates of MPL 515W>L/K mutation in essential thrombocythemia

Blood - Tập 112 - Trang 844-847 - 2008
Alessandro M. Vannucchi1,2, Elisabetta Antonioli1,2, Paola Guglielmelli1,2, Alessandro Pancrazzi1,2, Vittoria Guerini3, Giovanni Barosi4, Marco Ruggeri5, Giorgina Specchia6, Francesco Lo-Coco7, Federica Delaini3, Laura Villani4, Silvia Finotto5, Emanuele Ammatuna7, Renato Alterini1,2, Valentina Carrai1,2, Gloria Capaccioli1,2, Simonetta Di Lollo8, Vincenzo Liso6, Alessandro Rambaldi3, Alberto Bosi1,2
1Unita Funzionale di Ematologia, Dipartimento di Area Critica Medico-Chirurgica, Università degli Studi, Firenze
2Istituto Toscano Tumori, Firenze
3Divisione di Ematologia, Ospedali Riuniti, Bergamo
4Laboratorio di Epidemiologia Clinica, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo, Pavia
5Dipartimento di Ematologia e Centro per l'Emofilia e la Trombosi, Ospedale San Bortolo, Vicenza
6Dipartimento di Ematologia, Università degli Studi, Bari
7Dipartimento di Biopatologia e Diagnostica per Immagini, Università Tor Vergata, Roma
8Dipartimento di Oncologia, Università degli Studi, Firenze, Italy

Tóm tắt

Abstract Among 994 patients with essential thrombocythemia (ET) who were genotyped for the MPLW515L/K mutation, 30 patients carrying the mutation were identified (3.0%), 8 of whom also displayed the JAK2V671F mutation. MPLW515L/K patients presented lower hemoglobin levels and higher platelet counts than did wild type (wt) MPL; these differences were highly significant compared with MPLwt/JAK2V617F–positive patients. Reduced hemoglobin and increased platelet levels were preferentially associated with the W515L and W515K alleles, respectively. MPL mutation was a significant risk factor for microvessel disturbances, suggesting platelet hyperreactivity associated with constitutively active MPL; arterial thromboses were increased only in comparison to MPLwt/JAK2wt patients. MPLW515L/K patients presented reduced total and erythroid bone marrow cellularity, whereas the numbers of megakaryocytes, megakaryocytic clusters, and small-sized megakaryocytes were all significantly increased. These data indicate that MPLW515L/K mutations do not define a distinct phenotype in ET, although some differences depended on the JAK2V617F mutational status of the counterpart.

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