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Chronic Myeloproliferative Neoplasias

JAK2 germline genetic variation affects disease susceptibility in primary myelofibrosis regardless of V617F mutational status: nullizygosity for the JAK2 46/1 haplotype is associated with inferior survival

Abstract

A common JAK2 germline haplotype (46/1) has been associated with JAK2V617F (VF)-positive myeloproliferative neoplasms. The rs12343867 SNP (C/T) tags this haplotype. A total of 130 patients (77 VF-positive) with primary myelofibrosis (PMF) were analyzed for this informative SNP, using bone marrow-derived DNA. The observed 46/1 C allele frequencies in VF-positive (50%) and VF-negative (36%) patients were both significantly higher than expected in population controls (P<0.01). Genotype distributions in VF-positive/VF-negative patients were CC 31%/9%, CT 38%/53% and TT 31%/38% (P=0.01). CC genotype/C-allele frequencies in patients with <20% VF mutation burden (12%/37%) were similar (P=0.95) to those seen in VF-negative patients (9%/36%), but were significantly lower (P<0.01) than those seen in the presence of >50% mutation burden (67%/71%). The rs12343867 genotype did not correlate with the International Prognostic Scoring System (IPSS) score or karyotype. Unexpectedly, the TT genotype was associated with shortened survival (P<0.01), which was not accounted for by IPSS score or VF allele burden. We conclude that JAK2 germline genetic variation affects disease susceptibility, and possibly survival, in PMF, regardless of VF mutational status. Allelic distortion from acquired uniparental disomy contributes to the appearance of a more pronounced effect on disease susceptibility in VF-positive patients, when studying clonally affected tissue.

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References

  1. James C, Ugo V, Le Couedic JP, Staerk J, Delhommeau F, Lacout C et al. A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia vera. Nature 2005; 434: 1144–1148.

    Article  CAS  Google Scholar 

  2. Vannucchi AM, Antonioli E, Guglielmelli P, Pardanani A, Tefferi A . Clinical correlates of JAK2V617F presence or allele burden in myeloproliferative neoplasms: a critical reappraisal. Leukemia 2008; 22: 1299–1307.

    Article  CAS  Google Scholar 

  3. Steensma DP, Dewald GW, Lasho TL, Powell HL, McClure RF, Levine RL et al. The JAK2 V617F activating tyrosine kinase mutation is an infrequent event in both ‘atypical’ myeloproliferative disorders and myelodysplastic syndromes. Blood 2005; 106: 1207–1209.

    Article  CAS  Google Scholar 

  4. Schmitt-Graeff AH, Teo SS, Olschewski M, Schaub F, Haxelmans S, Kirn A et al. JAK2V617F mutation status identifies subtypes of refractory anemia with ringed sideroblasts associated with marked thrombocytosis. Haematologica 2008; 93: 34–40.

    Article  CAS  Google Scholar 

  5. Nishii K, Nanbu R, Lorenzo VF, Monma F, Kato K, Ryuu H et al. Expression of the JAK2 V617F mutation is not found in de novo AML and MDS but is detected in MDS-derived leukemia of megakaryoblastic nature. Leukemia 2007; 21: 1337–1338.

    Article  CAS  Google Scholar 

  6. Scott LM, Campbell PJ, Baxter EJ, Todd T, Stephens P, Edkins S et al. The V617F JAK2 mutation is uncommon in cancers and in myeloid malignancies other than the classic myeloproliferative disorders. Blood 2005; 106: 2920–2921.

    Article  CAS  Google Scholar 

  7. Kilpivaara O, Levine RL . JAK2 and MPL mutations in myeloproliferative neoplasms: discovery and science. Leukemia 2008; 22: 1813–1817.

    Article  CAS  Google Scholar 

  8. Pardanani A, Lasho TL, Finke C, Hanson CA, Tefferi A . Prevalence and clinicopathologic correlates of JAK2 exon 12 mutations in JAK2V617F-negative polycythemia vera. Leukemia 2007; 21: 1960–1963.

    Article  CAS  Google Scholar 

  9. Scott LM, Tong W, Levine RL, Scott MA, Beer PA, Stratton MR et al. JAK2 exon 12 mutations in polycythemia vera and idiopathic erythrocytosis. N Engl J Med 2007; 356: 459–468.

    Article  CAS  Google Scholar 

  10. Pikman Y, Lee BH, Mercher T, McDowell E, Ebert BL, Gozo M et al. MPLW515 L is a novel somatic activating mutation in myelofibrosis with myeloid metaplasia. PLoS Med 2006; 3: e270.

    Article  Google Scholar 

  11. Pardanani AD, Levine RL, Lasho T, Pikman Y, Mesa RA, Wadleigh M et al. MPL515 mutations in myeloproliferative and other myeloid disorders: a study of 1182 patients. Blood 2006; 108: 3472–3476.

    Article  CAS  Google Scholar 

  12. Tefferi A, Levine RL, Lim KH, Abdel-Wahab O, Lasho TL, Patel J et al. Frequent TET2 mutations in systemic mastocytosis: clinical, KITD816 V and FIP1L1-PDGFRA correlates. Leukemia 2009; 23: 900–904.

    Article  CAS  Google Scholar 

  13. Tefferi A, Pardanani A, Lim KH, Abdel-Wahab O, Lasho TL, Patel J et al. TET2 mutations and their clinical correlates in polycythemia vera, essential thrombocythemia and myelofibrosis. Leukemia 2009; 23: 905–911.

    Article  CAS  Google Scholar 

  14. Tefferi A, Lim KH, Abdel-Wahab O, Lasho TL, Patel J, Patnaik MM et al. Detection of mutant TET2 in myeloid malignancies other than myeloproliferative neoplasms: CMML, MDS, MDS/MPN and AML. Leukemia 2009; 23: 1343–1345.

    Article  CAS  Google Scholar 

  15. Pardanani A, Lasho TL, Finke C, Mesa RA, Hogan WJ, Ketterling RP et al. Extending Jak2V617F and MplW515 mutation analysis to single hematopoietic colonies and B and T lymphocytes. Stem Cells 2007; 25: 2358–2362.

    Article  CAS  Google Scholar 

  16. Kralovics R, Teo SS, Li S, Theocharides A, Buser AS, Tichelli A et al. Acquisition of the V617F mutation of JAK2 is a late genetic event in a subset of patients with myeloproliferative disorders. Blood 2006; 108: 1377–1380.

    Article  CAS  Google Scholar 

  17. Campbell PJ, Baxter EJ, Beer PA, Scott LM, Bench AJ, Huntly BJ et al. Mutation of JAK2 in the myeloproliferative disorders: timing, clonality studies, cytogenetic associations, and role in leukemic transformation. Blood 2006; 108: 3548–3555.

    Article  CAS  Google Scholar 

  18. Lambert JR, Everington T, Linch DC, Gale RE . In essential thrombocythemia, multiple JAK2-V617F clones are present in most mutant-positive patients: a new disease paradigm. Blood 2009; 114: 3018–3023.

    Article  CAS  Google Scholar 

  19. Kralovics R, Passamonti F, Buser AS, Teo SS, Tiedt R, Passweg JR et al. A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 2005; 352: 1779–1790.

    Article  CAS  Google Scholar 

  20. Scott LM, Scott MA, Campbell PJ, Green AR . Progenitors homozygous for the V617F mutation occur in most patients with polycythemia vera, but not essential thrombocythemia. Blood 2006; 108: 2435–2437.

    Article  CAS  Google Scholar 

  21. Tiedt R, Hao-Shen H, Sobas MA, Looser R, Dirnhofer S, Schwaller J et al. Ratio of mutant JAK2-V617F to wild-type Jak2 determines the MPD phenotypes in transgenic mice. Blood 2008; 111: 3931–3940.

    Article  CAS  Google Scholar 

  22. Shide K, Shimoda HK, Kumano T, Karube K, Kameda T, Takenaka K et al. Development of ET, primary myelofibrosis and PV in mice expressing JAK2 V617F. Leukemia 2008; 22: 87–95.

    Article  CAS  Google Scholar 

  23. Lasho TL, Pardanani A, McClure RF, Mesa RA, Levine RL, Gary Gilliland D et al. Concurrent MPL515 and JAK2V617F mutations in myelofibrosis: chronology of clonal emergence and changes in mutant allele burden over time. Br J Haematol 2006; 135: 683–687.

    Article  CAS  Google Scholar 

  24. Pardanani A, Fridley BL, Lasho TL, Gilliland DG, Tefferi A . Host genetic variation contributes to phenotypic diversity in myeloproliferative disorders. Blood 2008; 111: 2785–2789.

    Article  CAS  Google Scholar 

  25. Jones AV, Chase A, Silver RT, Oscier D, Zoi K, Wang YL et al. JAK2 haplotype is a major risk factor for the development of myeloproliferative neoplasms. Nat Genet 2009; 41: 446–449.

    Article  CAS  Google Scholar 

  26. Olcaydu D, Harutyunyan A, Jager R, Berg T, Gisslinger B, Pabinger I et al. A common JAK2 haplotype confers susceptibility to myeloproliferative neoplasms. Nat Genet 2009; 41: 450–454.

    Article  CAS  Google Scholar 

  27. Kilpivaara O, Mukherjee S, Schram AM, Wadleigh M, Mullally A, Ebert BL et al. A germline JAK2 SNP is associated with predisposition to the development of JAK2(V617F)-positive myeloproliferative neoplasms. Nat Genet 2009; 41: 455–459.

    Article  CAS  Google Scholar 

  28. Olcaydu D, Skoda RC, Looser R, Li S, Cazzola M, Pietra D et al. The ‘GGCC’ haplotype of JAK2 confers susceptibility to JAK2 exon 12 mutation-positive polycythemia vera. Leukemia 2009; 23: 1924–1926.

    Article  CAS  Google Scholar 

  29. Thiele J, Vardiman JW, Pierre R, Brunning RD, Imbert M, Flandrin G . Chronic idiopathic myelofibrosis. In: Jaffe ES, Harris NL, Stein H, Vardiman JW (eds). World Health Organization Classification of Tumors: Tumours of the Haematopoietic and Lymphoid Tissues. International Agency for Research on Cancer (IARC) Press: Lyon, France, 2001. pp 35–38.

    Google Scholar 

  30. Vardiman JW, Harris NL, Brunning RD . The World Health Organization (WHO) classification of the myeloid neoplasms. Blood 2002; 100: 2292–2302.

    Article  CAS  Google Scholar 

  31. Tefferi A, Lasho TL, Huang J, Finke C, Mesa RA, Li CY et al. Low JAK2V617F allele burden in primary myelofibrosis, compared to either a higher allele burden or unmutated status, is associated with inferior overall and leukemia-free survival. Leukemia 2008; 22: 756–761.

    Article  CAS  Google Scholar 

  32. Cervantes F, Dupriez B, Pereira A, Passamonti F, Reilly JT, Morra E et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood 2009; 113: 2895–2901.

    Article  CAS  Google Scholar 

  33. Hussein K, Huang J, Lasho T, Pardanani A, Mesa RA, Williamson CM et al. Karyotype complements the International Prognostic Scoring System for primary myelofibrosis. Eur J Haematol 2009; 82: 255–259.

    Article  Google Scholar 

  34. Tam CS, Abruzzo LV, Lin KI, Cortes J, Lynn A, Keating MJ et al. The role of cytogenetic abnormalities as a prognostic marker in primary myelofibrosis: applicability at the time of diagnosis and later during disease course. Blood 2009; 113: 4171–4178.

    Article  CAS  Google Scholar 

  35. Hidaka T, Shide K, Shimoda H, Kameda T, Toyama K, Katayose K et al. The impact of cytogenetic abnormalities on the prognosis of primary myelofibrosis: a prospective survey of 202 cases in Japan. Eur J Haematol 2009; 83: 328–333.

    Article  Google Scholar 

  36. Tefferi A, Lasho TL, Schwager SM, Steensma DP, Mesa RA, Li CY et al. The JAK2 tyrosine kinase mutation in myelofibrosis with myeloid metaplasia: lineage specificity and clinical correlates. Br J Haematol 2005; 131: 320–328.

    Article  CAS  Google Scholar 

  37. Guglielmelli P, Barosi G, Specchia G, Rambaldi A, Lo Coco F, Antonioli E et al. Identification of patients with poorer survival in primary myelofibrosis based on the burden of JAK2V617F mutated allele. Blood 2009; 114: 1477–1483.

    Article  CAS  Google Scholar 

  38. Pardanani A, Lasho T, Smith G, Burns CJ, Fantino E, Tefferi A . CYT387, a selective JAK1/JAK2 inhibitor: in vitro assessment of kinase selectivity and preclinical studies using cell lines and primary cells from polycythemia vera patients. Leukemia 2009; 23: 1441–1445.

    Article  CAS  Google Scholar 

  39. Pardanani A, Hood J, Lasho T, Levine RL, Martin MB, Noronha G et al. TG101209, a small molecule JAK2-selective kinase inhibitor potently inhibits myeloproliferative disorder-associated JAK2V617F and MPLW515 L/K mutations. Leukemia 2007; 21: 1658–1668.

    Article  CAS  Google Scholar 

  40. Lasho TL, Tefferi A, Hood JD, Verstovsek S, Gilliland DG, Pardanani A . TG101348, a JAK2-selective antagonist, inhibits primary hematopoietic cells derived from myeloproliferative disorder patients with JAK2V617F, MPLW515 K or JAK2 exon 12 mutations as well as mutation negative patients. Leukemia 2008; 22: 1790–1792.

    Article  CAS  Google Scholar 

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Tefferi, A., Lasho, T., Patnaik, M. et al. JAK2 germline genetic variation affects disease susceptibility in primary myelofibrosis regardless of V617F mutational status: nullizygosity for the JAK2 46/1 haplotype is associated with inferior survival. Leukemia 24, 105–109 (2010). https://doi.org/10.1038/leu.2009.225

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