1
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Langabeer SE, Burke Á. Persisting with persistent thrombocytosis. Int J Lab Hematol 2023; 45:816-817. [PMID: 37218366 DOI: 10.1111/ijlh.14105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Affiliation(s)
| | - Áine Burke
- Department of Haematology, Sligo University Hospital, Sligo, Ireland
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2
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Mroczkowska-Bękarciak A, Wróbel T. BCR::ABL1-negative myeloproliferative neoplasms in the era of next-generation sequencing. Front Genet 2023; 14:1241912. [PMID: 37745842 PMCID: PMC10514516 DOI: 10.3389/fgene.2023.1241912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
The classical BCR::ABL1-negative myeloproliferative neoplasms such as polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF) are clonal diseases with the presence of characteristic "driver mutations" in one of the genes: JAK2, CALR, or MPL. The search for mutations in these three genes is required for the diagnosis of MPNs. Nevertheless, the progress that has been made in the field of molecular genetics has opened a new era in medicine. The search for additional mutations in MPNs is helpful in assessing the risk stratification, disease progression, transformation to acute myeloid leukemia (AML), or choosing the right treatment. In some cases, advanced technologies are needed to find a clonal marker of the disease and establish a diagnosis. This review focuses on how the use of new technologies like next-generation sequencing (NGS) helps in the diagnosis of BCR::ABL1-negative myeloproliferative neoplasms.
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Giraldo-Rincón AI, Naranjo Molina S, Gomez-Lopera N, Aguirre Acevedo D, Ucroz Benavidez A, Gálvez Cárdenas K, Cuellar Ambrosí F, Torres JD, Ospina S, Palacio K, Gaviria Jaramillo L, Muñeton CM, Vasquez Palacio G. JAK2, CALR, and MPL Mutation Profiles in Colombian patients with BCR-ABL Negative Myeloproliferative Neoplasms. Colomb Med (Cali) 2023; 54:e2035353. [PMID: 38111518 PMCID: PMC10726695 DOI: 10.25100/cm.v54i3.5353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/25/2023] [Indexed: 12/20/2023] Open
Abstract
Background Among the chronic myeloproliferative neoplasms (MPNs) not associated with BCR-ABL mutations are polycythemia vera, primary myelofibrosis, and essential thrombocythemia. These diseases are caused by mutations in genes, such as the JAK2, MPL, and CALR genes, which participate in regulating the JAK-STAT signaling pathway. Objective This study aimed to establish the frequencies of mutations in the JAK2, MPL, and CALR genes in a group of Colombian patients with a negative clinical diagnosis of BCR-ABL chronic myeloproliferative neoplasms. Methods The JAK2 V617F and MPL W515K mutations and deletions or insertions in exon 9 of the CALR gene were analyzed in 52 Colombian patients with polycythemia vera, primary myelofibrosis, and essential thrombocythemia. Results The JAK2V617F mutation was carried by 51.9% of the patients, the CALR mutation by 23%, and the MPL mutation by 3.8%; 23% were triple-negative for the mutations analyzed. In these neoplasms, 6 mutation types in CALR were identified, one of which has not been previously reported. Additionally, one patient presented a double mutation in both the CALR and JAK2 genes. Regarding the hematological results for the mutations, significant differences were found in the hemoglobin level, hematocrit level, and platelet count among the three neoplasms. Conclusion Thus, this study demonstrates the importance of the molecular characterization of the JAK2, CALR and MPL mutations in Colombian patients (the genetic context of which remains unclear in the abovementioned neoplasms) to achieve an accurate diagnosis, a good prognosis, adequate management, and patient survival.
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Affiliation(s)
| | - Sara Naranjo Molina
- Universidad de Antioquia, Facultad de Medicina, Unidad de Genética Médica, Medellín, Colombia
| | - Natalia Gomez-Lopera
- Universidad de Antioquia, Facultad de Medicina, Unidad de Genética Médica, Medellín, Colombia
| | | | - Andrea Ucroz Benavidez
- Universidad de Antioquia, Facultad de Medicina, Unidad de Genética Médica, Medellín, Colombia
| | | | | | | | - Sigifredo Ospina
- Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Katherine Palacio
- Universidad de Antioquia, Facultad de Medicina, Unidad de Genética Médica, Medellín, Colombia
| | | | - Carlos Mario Muñeton
- Universidad de Antioquia, Facultad de Medicina, Unidad de Genética Médica, Medellín, Colombia
| | - Gonzalo Vasquez Palacio
- Universidad de Antioquia, Facultad de Medicina, Unidad de Genética Médica, Medellín, Colombia
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4
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Abdelghani M, Hammami H, Zidi W, Amouri H, Othmen HBH, Farrah A, Menif S. Hematological relevance of JAK2 V617F and calreticulin mutations in Tunisian patients with essential thrombocythemia. J Clin Lab Anal 2022; 36:e24522. [PMID: 35754115 PMCID: PMC9396186 DOI: 10.1002/jcla.24522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/14/2022] Open
Abstract
Background The genetic investigation of essential thrombocythemia(ET) has highlighted the presence of driver mutations in ET. Janus kinase JAK2V617F and calreticulin(CALR) mutations are the most frequent driver mutations and have significantly improved the molecular diagnosis of ET. The impact of genetic heterogeneity on clinical features has not been fully elucidated. This is the first study which aimed to determine the frequency of JAK2V617F and CALR exon9 mutations in Tunisian ET patients and to establish the correlation between hematological characteristics and mutational status. Methods This study included Tunisian patients suspected with ET and was conducted between September 2017 and March 2021. Genomic DNA of patients was isolated from peripheral blood samples. JAK2V617F was detected by AS‐PCR and CALR mutations were detected by PCR/direct sequencing. Clinical and hematological characteristics were also analyzed. Results Two hundred and fifty ET patients were enrolled in this study. JAK2V617F mutation was found in 166/250 (66.4%) of patients, whereas CALR mutations were detected in 27/84 (32.1%) patients without JAK2V617F. Compared with JAK2V617F‐positive patients, those with CALR mutations showed lower hemoglobin level and lower leucocytes count (p = 0.007 and p = 0.004,respectively). CALR type 2 was the most frequent mutation of CALR detected in 55.55% of CALR mutated. Six of seven patients with thrombotic events harbored JAK2V617F mutation. Conclusion The prevalence of driver mutations JAK2V617F or CALR mutations was 77.2% in Tunisian ET patients. Moreover, patients with JAK2 V617F mutation had a higher risk of thrombosis. The mutational status is necessary to improve the diagnosis and contribute to the therapeutic decisions.
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Affiliation(s)
- Maroua Abdelghani
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Faculty of Mathematics, Physics and Natural Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Haifa Hammami
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Faculty of Mathematics, Physics and Natural Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wiem Zidi
- Laboratory of Biochemistry, Rabta Hospital, Tunis, Tunisia
| | - Hassiba Amouri
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Hind Ben Hadj Othmen
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ahlem Farrah
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Samia Menif
- LR16IPT07, Molecular and Cellular Hematology Laboratory, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
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5
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Easwar A, Siddon AJ. Genetic Landscape of Myeloproliferative Neoplasms with an Emphasis on Molecular Diagnostic Laboratory Testing. Life (Basel) 2021; 11:1158. [PMID: 34833034 PMCID: PMC8625510 DOI: 10.3390/life11111158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/18/2021] [Accepted: 10/27/2021] [Indexed: 12/27/2022] Open
Abstract
Chronic myeloproliferative neoplasms (MPNs) are hematopoietic stem cell neoplasms with driver events including the BCR-ABL1 translocation leading to a diagnosis of chronic myeloid leukemia (CML), or somatic mutations in JAK2, CALR, or MPL resulting in Philadelphia-chromosome-negative MPNs with constitutive activation of the JAK-STAT signaling pathway. In the Philadelphia-chromosome-negative MPNs, modern sequencing panels have identified a vast molecular landscape including additional mutations in genes involved in splicing, signal transduction, DNA methylation, and chromatin modification such as ASXL1, SF3B1, SRSF2, and U2AF1. These additional mutations often influence prognosis in MPNs and therefore are increasingly important for risk stratification. This review focuses on the molecular alterations within the WHO classification of MPNs and laboratory testing used for diagnosis.
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Affiliation(s)
- Arti Easwar
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06510, USA;
| | - Alexa J. Siddon
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06510, USA;
- Department of Pathology, Yale School of Medicine, New Haven, CT 06510, USA
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6
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Lee Tokar L, Crotty G, O'Keeffe D, Langabeer SE. Myeloproliferative neoplasms with a low (<5%) CALR mutation allele burden. Blood Cells Mol Dis 2021; 90:102593. [PMID: 34217938 DOI: 10.1016/j.bcmd.2021.102593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lisa Lee Tokar
- Cancer Molecular Diagnostics, St. James's Hospital, Dublin, Ireland
| | - Gerard Crotty
- Department of Haematology, Midlands Regional Hospital, Tullamore, Ireland
| | - Denis O'Keeffe
- Department of Haematology, University Hospital Limerick, Limerick, Ireland
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7
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Lemoine S, Renard M, Bouvier A, Orvain C, Giltat A, Cottin L, Blanchet O, Hunault-Berger M, Ugo V, Luque Paz D. No detection of atypical one-base deletion of CALR exon 9 with fragment analysis: A molecular trap to avoid. Blood Cells Mol Dis 2021; 90:102589. [PMID: 34214802 DOI: 10.1016/j.bcmd.2021.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Sandrine Lemoine
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France.
| | - Maxime Renard
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France
| | - Anne Bouvier
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France
| | - Corentin Orvain
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France; CHU Angers, Service des maladies du sang, Angers, France
| | - Aurélien Giltat
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France; CHU Angers, Service des maladies du sang, Angers, France
| | - Laurane Cottin
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France
| | - Odile Blanchet
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France; CHU Angers, Centre de Ressources Biologiques, BB-0033-00038, Angers, France
| | - Mathilde Hunault-Berger
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France; CHU Angers, Service des maladies du sang, Angers, France
| | - Valérie Ugo
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France
| | - Damien Luque Paz
- Univ Angers, Inserm, CRCINA, F-49000 Angers, France; CHU Angers, Laboratoire d'hématologie, F-49000 Angers, France; Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), France
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8
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Naseem S, Binota J, Varma N, Satyarthi P, Rana P, Malhotra P. Polymerase chain reaction-restriction fragment length polymorphism method for detection of Calreticulin type-1 and type-2 mutations in myeloproliferative neoplasm. J Hematop 2021. [DOI: 10.1007/s12308-021-00462-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Kurochkin DV, Maslyukova IE, Subbotina TN, Khazieva AS, Vasiliev EV, Mikhalev MA, Dunaeva EA, Mironov KO. Screening of somatic mutations in the JAK2 and CALR genes by high-resolution melting curve analysis. Klin Lab Diagn 2021; 66:315-320. [PMID: 34047519 DOI: 10.51620/0869-2084-2021-66-5-315-320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Somatic mutations associated with oncological diseases, including Ph-myeloproliferative neoplasms (Ph-MPN), are very diverse, occur with different frequencies and different allelic burden levels. Therefore, at the initial stage of performing molecular-genetic diagnostic procedures, it is desirable to be able to conduct screening tests in the laboratory. This is especially important when analyzing rare and diverse mutations. Analysis of high resolution melting curves (HRM analysis), which has high sensitivity and is suitable for screening all types of mutations, in a number of studies is proposed for the analysis of Ph-MPN associated mutations in the JAK2 and CALR genes. For analysis of somatic mutations in the majority of literature sources that we reviewed, the authors use the LightCycler (Roche) thermocycler and much rarely the CFX96 (Bio-Rad), which is often presented in Russian scientific and practical and medical organizations. The aim of the study was to screen the somatic JAK2 and CALR mutations by HRM analysis using the CFX96 thermocycler and the Precision Melt Analysis software (Bio-Rad, USA) for patients with Ph-MPN. In the present research, HRM analysis was conducted on the DNA samples from patients with mutations in the JAK2 or in the CALR gene. The Precision Melt Analysis software identified all variants of the analyzed mutations, both a single nucleotide substitution in the JAK2 gene (with allelic burden level in the range of 5-40%), and various indel mutations in the CALR gene (with allelic burden level in the range of 40-50%) Therefore, the HRM analysis that was conducted on the CFX96 allows screening of highly specific mutation for the diagnosis of Ph-MPN in the exon 14 of the JAK2 gene and in the exon 9 of the CALR gene. The inclusion of this screening research in the laboratory testing algorithm improves the efficiency and accessibility of molecular genetic technologies in the diagnosis of Ph-MPN.
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Affiliation(s)
| | | | - T N Subbotina
- Siberian Federal University.,The Federal Siberian Research Clinical Center under FMBA of Russia
| | | | | | | | - E A Dunaeva
- Central Research Institute of Epidemiology Rospotrebnadzor
| | - K O Mironov
- Central Research Institute of Epidemiology Rospotrebnadzor
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10
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Moncada A, Pancrazzi A. Lab tests for MPN. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2021; 366:187-220. [PMID: 35153004 DOI: 10.1016/bs.ircmb.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Molecular laboratory investigations for myeloproliferative neoplasm (MPN) can ideally be divided into two distincts groups, those for the detection of the BCR-ABL rearrangement (suspect of chronic myeloid leukemia) and those for the variants determination of the driver genes of the negative Philadelphia forms (MPN Ph neg). The BCR-ABL detection is based on RT-Polymerase Chain Reaction techniques and more recently on droplet digital PCR (ddPCR). For this type of analysis, combined with chromosome banding analysis (CBA) and Fluorescent in situ hybridization (FISH), it is essential to quantify BCR-ABL mutated copies by standard curve method. The investigation on driver genes for MPN Ph neg forms includes activity for erythroid forms such as Polycythemia Vera (test JAK2V617F and JAK2 exon 12), for non-erythroid forms such as essential thrombocythemia and myelofibrosis (test JAK2V617F, CALR exon 9, MPL exon 10), for "atypical" ones such as mastocytosis (cKIT D816V test) and for hypereosinophilic syndrome (FIP1L1-PDGFRalpha test). It's crucial to assign prognosis value through calculating allelic burden of JAK2 V617F variant and determining CALR esone 9 variants (type1/1like, type2/2like and atypical ones). A fundamental innovation for investigating triple negative cases for JAK2, CALR, MPL and for providing prognostic score is the use of Next Generation Sequencing panels containing high molecular risk genes as ASXL1, EZH2, TET2, IDH1/IDH2, SRSF2. This technique allows to detect additional or subclonal mutations which are usually acquired in varying sized sub-clones of hematopoietic progenitors. These additional variants have a prognostic significance and should be indagated to exclude false negative cases.
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Affiliation(s)
- Alice Moncada
- Laboratory Medicine Department, Molecular and Clinical Pathology Sector, Azienda USL Toscana Sudest, Ospedale San Donato, Arezzo, Italy
| | - Alessandro Pancrazzi
- Laboratory Medicine Department, Molecular and Clinical Pathology Sector, Azienda USL Toscana Sudest, Ospedale San Donato, Arezzo, Italy.
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11
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The Contemporary Approach to CALR-Positive Myeloproliferative Neoplasms. Int J Mol Sci 2021; 22:ijms22073371. [PMID: 33806036 PMCID: PMC8038093 DOI: 10.3390/ijms22073371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
CALR mutations are a revolutionary discovery and represent an important hallmark of myeloproliferative neoplasms (MPN), especially essential thrombocythemia and primary myelofibrosis. To date, several CALR mutations were identified, with only frameshift mutations linked to the diseased phenotype. It is of diagnostic and prognostic importance to properly define the type of CALR mutation and subclassify it according to its structural similarities to the classical mutations, a 52-bp deletion (type 1 mutation) and a 5-bp insertion (type 2 mutation), using a statistical approximation algorithm (AGADIR). Today, the knowledge on the pathogenesis of CALR-positive MPN is expanding and several cellular mechanisms have been recognized that finally cause a clonal hematopoietic expansion. In this review, we discuss the current basis of the cellular effects of CALR mutants and the understanding of its implementation in the current diagnostic laboratorial and medical practice. Different methods of CALR detection are explained and a diagnostic algorithm is shown that aids in the approach to CALR-positive MPN. Finally, contemporary methods joining artificial intelligence in accordance with molecular-genetic biomarkers in the approach to MPN are presented.
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12
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Verger E, Maslah N, Schlageter M, Chomienne C, Kiladjian J, Giraudier S, Cassinat B. Pitfalls in CALR exon 9 mutation detection: A single‐center experience in 571 positive patients. Int J Lab Hematol 2020; 42:827-832. [DOI: 10.1111/ijlh.13282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/02/2020] [Accepted: 06/10/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Emmanuelle Verger
- Laboratoire de Biologie Cellulaire AP‐HP Hopital Saint‐Louis Paris France
- Université de Paris U1131 INSERM IRSL Paris France
| | - Nabih Maslah
- Laboratoire de Biologie Cellulaire AP‐HP Hopital Saint‐Louis Paris France
- Université de Paris U1131 INSERM IRSL Paris France
| | - Marie‐Helene Schlageter
- Laboratoire de Biologie Cellulaire AP‐HP Hopital Saint‐Louis Paris France
- Université de Paris U1131 INSERM IRSL Paris France
| | - Christine Chomienne
- Laboratoire de Biologie Cellulaire AP‐HP Hopital Saint‐Louis Paris France
- Université de Paris U1131 INSERM IRSL Paris France
| | - Jean‐Jacques Kiladjian
- Université de Paris U1131 INSERM IRSL Paris France
- Laboratoire d’Excellence GR‐Ex Paris France
- Centre d’Investigations Cliniques Hopital Saint‐Louis Paris France
| | - Stephane Giraudier
- Laboratoire de Biologie Cellulaire AP‐HP Hopital Saint‐Louis Paris France
- Université de Paris U1131 INSERM IRSL Paris France
- Laboratoire d’Excellence GR‐Ex Paris France
| | - Bruno Cassinat
- Laboratoire de Biologie Cellulaire AP‐HP Hopital Saint‐Louis Paris France
- Université de Paris U1131 INSERM IRSL Paris France
- Laboratoire d’Excellence GR‐Ex Paris France
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13
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Saleh LM, Algamal R, Abd Elmasseh H, Barber E, Abdel-ghaffar H. Different CALR mutation subtypes in essential thrombocythemia and primary myelofibrosis patients without JAK2 mutation. MEMO - MAGAZINE OF EUROPEAN MEDICAL ONCOLOGY 2020; 13:235-243. [DOI: 10.1007/s12254-020-00584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 02/11/2020] [Indexed: 09/02/2023]
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14
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CAL2 monoclonal antibody is a rapid and sensitive assay for the detection of calreticulin mutations in essential thrombocythemia patients. Ann Hematol 2019; 98:2339-2346. [DOI: 10.1007/s00277-019-03741-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 06/15/2019] [Indexed: 10/26/2022]
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15
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Doyle LJ, Betz BL, Weigelin HC, Procop GW, Cook JR. Comparison of real‐time PCR vs PCR with fragment length analysis for the detection of
CALR
mutations in suspected myeloproliferative neoplasms. Int J Lab Hematol 2019; 41:e139-e141. [DOI: 10.1111/ijlh.13040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Laura J. Doyle
- Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland Ohio
| | - Bryan L. Betz
- University of Michigan School of Medicine Ann Arbor Michigan
| | | | - Gary W. Procop
- Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland Ohio
| | - James R. Cook
- Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland Ohio
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Palumbo GA, Stella S, Pennisi MS, Pirosa C, Fermo E, Fabris S, Cattaneo D, Iurlo A. The Role of New Technologies in Myeloproliferative Neoplasms. Front Oncol 2019; 9:321. [PMID: 31106152 PMCID: PMC6498877 DOI: 10.3389/fonc.2019.00321] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
The hallmark of BCR-ABL1-negative myeloproliferative neoplasms (MPNs) is the presence of a driver mutation in JAK2, CALR, or MPL gene. These genetic alterations represent a key feature, useful for diagnostic, prognostic and therapeutical approaches. Molecular biology tests are now widely available with different specificity and sensitivity. Recently, the allele burden quantification of driver mutations has become a useful tool, both for prognostication and efficacy evaluation of therapies. Moreover, other sub-clonal mutations have been reported in MPN patients, which are associated with poorer prognosis. ASXL1 mutation appears to be the worst amongst them. Both driver and sub-clonal mutations are now taken into consideration in new prognostic scoring systems and may be better investigated using next generation sequence (NGS) technology. In this review we summarize the value of NGS and its contribution in providing a comprehensive picture of mutational landscape to guide treatment decisions. Finally, discussing the role that NGS has in defining the potential risk of disease development, we forecast NGS as the standard molecular biology technique for evaluating these patients.
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Affiliation(s)
- Giuseppe A Palumbo
- Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Stefania Stella
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Maria Stella Pennisi
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Cristina Pirosa
- Postgraduate School of Hematology, University of Catania, Catania, Italy
| | - Elisa Fermo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sonia Fabris
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Iurlo
- Hematology Division, Myeloproliferative Syndromes Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Detection of CALR Mutations Using High Resolution Melting Curve Analysis (HRM-A); Application on a Large Cohort of Greek ET and MF Patients. Mediterr J Hematol Infect Dis 2019; 11:e2019009. [PMID: 30671215 PMCID: PMC6328041 DOI: 10.4084/mjhid.2019.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/14/2018] [Indexed: 01/30/2023] Open
Abstract
Background and Objectives Somatic mutations in the calreticulin gene (CALR) are detected in approximately 70% of patients with essential thrombocythemia (ET) and primary or secondary myelofibrosis (MF), lacking the JAK2 and MPL mutations. To determine the prevalence of CALR frameshift mutations in a population of MPN patients of Greek origin, we developed a rapid low-budget PCR-based assay and screened samples from 5 tertiary Haematology units. This is a first of its kind report of the Greek patient population that also disclosed novel CALR mutants. Methods MPN patient samples were collected from different clinical units and screened for JAK2 and MPL mutations after informed consent was obtained. Negative samples were analyzed for the presence of CALR mutations. To this end, we developed a modified post Real Time PCR High-Resolution Melting Curve analysis (HRM-A) protocol. Samples were subsequently confirmed by Sanger sequencing. Results Using this protocol we screened 173 MPN, JAK2 and MPL mutation negative, patients of Greek origin, of whom 117 (67.63%) displayed a CALR exon nine mutation. More specifically, mutations were detected in 90 out of 130 (69.23%) essential thrombocythaemia cases (ET), in 18 out of 33 (54.55%) primary myelofibrosis patients (pMF) and in 9 out of 10 (90%) cases of myelofibrosis secondary to ET (post-ET sMF). False positive results were not detected. The limit of detection (LoD) of our protocol was 2%. Furthermore, our study revealed six rare novel mutations which are to be added in the COSMIC database. Conclusions Overall, our method could rapidly and cost-effectively detect the mutation status in a representative cohort of Greek patients; the mutation make-up in our group was not different from what has been published for other national groups.
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Tang Y, Shi C, Wu Z, Fan N, Xu X, Kang Z, Zhang X, Ma W, Guan M. A triplex probe-based TaqMan qPCR assay for Calreticulin type I and II mutation detection. ACTA ACUST UNITED AC 2018; 24:26-31. [PMID: 30080988 DOI: 10.1080/10245332.2018.1502944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Calreticulin (CALR) exon 9 frameshift mutations have recently been identified in 30-40% of patients with essential thrombocythemia (ET) and primary myelofibrosis (PMF) without JAK2 or MPL mutations. We aimed to develop a qPCR assay to screen type I and II mutations of CALR. METHODS Three different fluorescent-labeled hydrolysis probes and one pair of primers in a closed-tube system were developed to detect CALR type I and II mutations and distinguish them from wild-type. The sensitivity and specificity were validated using TA-cloning plasmids containing CALR wild-type and type I and II mutants, respectively. Fifty-nine ET and PMF specimens were screened by TaqMan qPCR and sequenced by Sanger sequencing. For intra-assay validation, 20 replicates of the assay were performed with each sample. For inter-assay validation, four replications of each sample were carried out and repeated continuously for 5 days. RESULTS We found that triplex probe-based TaqMan qPCR was reliable in detecting CALR type I and II mutants within DNA that was diluted to 1% of total DNA with the wild-type DNA as background. In 59 patient specimens, six of the observed mutations of CALR were type I and five were type II. Genotyping results obtained from TaqMan qPCR were 100% concordant with Sanger sequencing. The intra- and inter-assay CVs of TaqMan qPCR were less than 3%, respectively. CONCLUSIONS Triplex probe-based TaqMan qPCR is an accurate and sensitive method for screening ET or PMF patients with type I and II mutations in CALR.
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Affiliation(s)
- Yigui Tang
- a Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Changgen Shi
- b China National Population and Family Planning Key Laboratory of Contraceptive Drugs and Device , Shanghai Institute of Planned Parenthood Research(SIPPR) , Shanghai , People's Republic of China.,c School of Life Sciences , Fudan University , Shanghai , People's Republic of China
| | - Zhiyuan Wu
- d Department of Laboratory Medicine, Huashan Hospital North, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Ni Fan
- e Department of Hematology, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Xiao Xu
- f Department of Central Laboratory, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Zhihua Kang
- a Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Xinju Zhang
- f Department of Central Laboratory, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Weizhe Ma
- f Department of Central Laboratory, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
| | - Ming Guan
- a Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China.,f Department of Central Laboratory, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , People's Republic of China
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19
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Oh Y, Song IC, Kim J, Kwon GC, Koo SH, Kim SY. Pyrosequencing-based quantitative measurement of CALR mutation allele burdens and their clinical implications in patients with myeloproliferative neoplasms. Clin Chim Acta 2018; 483:183-191. [DOI: 10.1016/j.cca.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/17/2018] [Accepted: 05/01/2018] [Indexed: 12/26/2022]
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21
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Catherwood MA, Graham A, Cuthbert RJG, Garrec C, Gardie B, Girodon F, Laird S, Cross NCP, McMullin MF. Absence of CALR Mutations in Idiopathic Erythrocytosis Patients with Low Serum Erythropoietin Levels. Acta Haematol 2018; 139:217-219. [PMID: 29847812 DOI: 10.1159/000489006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Mark A Catherwood
- Clinical Haematology, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Amy Graham
- Clinical Haematology, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Robert J G Cuthbert
- Clinical Haematology, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Celine Garrec
- Ecole Pratique des Hautes Etudes (EPHE), PSL Research University, Paris, France
- INSERM U892, CNRS 6299, Université de Nantes, Nantes, France
| | - Betty Gardie
- Ecole Pratique des Hautes Etudes (EPHE), PSL Research University, Paris, France
- INSERM U892, CNRS 6299, Université de Nantes, Nantes, France
| | - François Girodon
- Service d'Hématologie Biologique CHU Dijon, Dijon, France
- INSERM, UMR866, University of Burgundy Franche-Comté, Dijon, France
| | - Sophie Laird
- Wessex Regional Genetics Laboratory, Salisbury, United Kingdom
| | | | - Mary Frances McMullin
- Clinical Haematology, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom
- Centre for Medical Education (CME), Queen's University Belfast, Belfast, United Kingdom
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22
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Haslam K, Dell S, Atkinson E, Enright H, Thornton P, Langabeer SE. False-negative CALR mutation in a suspected myeloproliferative neoplasm: identification, resolution and corrective action. J Clin Pathol 2018; 71:473-474. [DOI: 10.1136/jclinpath-2018-205029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 01/31/2018] [Accepted: 02/06/2018] [Indexed: 11/03/2022]
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Bilbao-Sieyro C, Florido Y, Gómez-Casares MT. CALR mutation characterization in myeloproliferative neoplasms. Oncotarget 2018; 7:52614-52617. [PMID: 27384487 PMCID: PMC5288135 DOI: 10.18632/oncotarget.10376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/13/2016] [Indexed: 12/20/2022] Open
Abstract
Identification of somatic frameshift mutations in exon 9 of the calreticulin gene (CALR) in myeloproliferative neoplasms (MPNs) in December of 2013 has been a remarkable finding. It has provided a new molecular diagnostic marker, particularly in essential thrombocythemia (ET) and primary myelofibrosis (PMF), where is the second most common altered gene after JAK2V617F. There are two main types of CALR mutants, type 1 and type 2, and there is evidence about their distinct clinical/prognostic implications, for instances, it is believed that favorable outcome might be restricted to type-1 in PMF. By using reasoned approaches, very recent publications have supported classifying the alternative mutants in type-1-like or type-2-like. If further studies confirm these results, new considerations may be taken into account in the molecular diagnosis of MPNs. This implies that precise mutation characterization must be performed and caution should be taken in screening technique selection. In this Editorial we summarize the current information regarding all this issues.
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Affiliation(s)
- Cristina Bilbao-Sieyro
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain.,Morfology Department, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Yanira Florido
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
| | - María Teresa Gómez-Casares
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
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24
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Frawley T, O'Brien CP, Conneally E, Vandenberghe E, Percy M, Langabeer SE, Haslam K. Development of a Targeted Next-Generation Sequencing Assay to Detect Diagnostically Relevant Mutations of JAK2, CALR, and MPL in Myeloproliferative Neoplasms. Genet Test Mol Biomarkers 2018; 22:98-103. [PMID: 29323541 DOI: 10.1089/gtmb.2017.0203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The classical Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs), consisting of polycythemia vera, essential thrombocythemia, and primary myelofibrosis, are a heterogeneous group of neoplasms that harbor driver mutations in the JAK2, CALR, and MPL genes. The detection of mutations in these genes has been incorporated into the recent World Health Organization (WHO) diagnostic criteria for MPN. Given a pressing clinical need to screen for mutations in these genes in a routine diagnostic setting, a targeted next-generation sequencing (NGS) assay for the detection of MPN-associated mutations located in JAK2 exon 14, JAK2 exon 12, CALR exon 9, and MPL exon 10 was developed to provide a single platform alternative to reflexive, stepwise diagnostic algorithms. METHODS Polymerase chain reaction (PCR) primers were designed to target mutation hotspots in JAK2 exon 14, JAK2 exon 12, MPL exon 10, and CALR exon 9. Multiplexed PCR conditions were optimized by using qualitative PCR followed by NGS. Diagnostic genomic DNA from 35 MPN patients, known to harbor driver mutations in one of the target genes, was used to validate the assay. RESULTS One hundred percent concordance was observed between the previously-identified mutations and those detected by NGS, with no false positives, nor any known mutations missed (specificity = 100%, CI = 0.96, sensitivity = 100%, CI = 0.89). Improved resolution of mutation sequences was also revealed by NGS analysis. CONCLUSION Detection of diagnostically relevant driver mutations of MPN is enhanced by employing a targeted multiplex NGS approach. This assay presents a robust solution to classical MPN mutation screening, providing an alternative to time-consuming sequential analyses.
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Affiliation(s)
- Thomas Frawley
- 1 Cancer Molecular Diagnostics, St. James's Hospital , Dublin, Ireland
| | - Cathal P O'Brien
- 1 Cancer Molecular Diagnostics, St. James's Hospital , Dublin, Ireland
| | | | | | - Melanie Percy
- 3 Department of Haematology, Belfast City Hospital , Belfast, United Kingdom
| | | | - Karl Haslam
- 1 Cancer Molecular Diagnostics, St. James's Hospital , Dublin, Ireland
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Harrison CN, Mead AJ, Panchal A, Fox S, Yap C, Gbandi E, Houlton A, Alimam S, Ewing J, Wood M, Chen F, Coppell J, Panoskaltsis N, Knapper S, Ali S, Hamblin A, Scherber R, Dueck AC, Cross NCP, Mesa R, McMullin MF. Ruxolitinib vs best available therapy for ET intolerant or resistant to hydroxycarbamide. Blood 2017; 130:1889-1897. [PMID: 29074595 PMCID: PMC6410531 DOI: 10.1182/blood-2017-05-785790] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/24/2017] [Indexed: 01/11/2023] Open
Abstract
Treatments for high-risk essential thrombocythemia (ET) address thrombocytosis, disease-related symptoms, as well as risks of thrombosis, hemorrhage, transformation to myelofibrosis, and leukemia. Patients resistant/intolerant to hydroxycarbamide (HC) have a poor outlook. MAJIC (ISRCTN61925716) is a randomized phase 2 trial of ruxolitinib (JAK1/2 inhibitor) vs best available therapy (BAT) in ET and polycythemia vera patients resistant or intolerant to HC. Here, findings of MAJIC-ET are reported, where the modified intention-to-treat population included 58 and 52 patients randomized to receive ruxolitinib or BAT, respectively. There was no evidence of improvement in complete response within 1 year reported in 27 (46.6%) patients treated with ruxolitinib vs 23 (44.2%) with BAT (P = .40). At 2 years, rates of thrombosis, hemorrhage, and transformation were not significantly different; however, some disease-related symptoms improved in patients receiving ruxolitinib relative to BAT. Molecular responses were uncommon; there were 2 complete molecular responses (CMR) and 1 partial molecular response in CALR-positive ruxolitinib-treated patients. Transformation to myelofibrosis occurred in 1 CMR patient, presumably because of the emergence of a different clone, raising questions about the relevance of CMR in ET patients. Grade 3 and 4 anemia occurred in 19% and 0% of ruxolitinib vs 0% (both grades) in the BAT arm, and grade 3 and 4 thrombocytopenia in 5.2% and 1.7% of ruxolitinib vs 0% (both grades) of BAT-treated patients. Rates of discontinuation or treatment switching did not differ between the 2 trial arms. The MAJIC-ET trial suggests that ruxolitinib is not superior to current second-line treatments for ET. This trial was registered at www.isrctn.com as #ISRCTN61925716.
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Affiliation(s)
| | - Adam J Mead
- Weatherall Institute of Molecular Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Anesh Panchal
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Sonia Fox
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Christina Yap
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Emmanouela Gbandi
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Aimee Houlton
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Samah Alimam
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Joanne Ewing
- Heart of England NHS Foundation Trust, Birmingham, United Kingdom
| | - Marion Wood
- Colchester Hospital University NHS Foundation Trust, Colchester, United Kingdom
| | - Frederick Chen
- Centre for Clinical Hematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Jason Coppell
- Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Nicki Panoskaltsis
- Department of Hematology, London North West Healthcare NHS Trust, London, United Kingdom
| | - Steven Knapper
- Department of Hematology, Cardiff University, Cardiff, United Kingdom
| | - Sahra Ali
- Castle Hill Hospital, Hull, United Kingdom
| | - Angela Hamblin
- NIHR Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Robyn Scherber
- Department of Hematology and Oncology, Oregon Health and Sciences University, Portland, OR
- Mayo Clinic, Phoenix, AZ
| | - Amylou C Dueck
- Division of Health Sciences Research, Mayo Clinic, Scottsdale, AZ
| | - Nicholas C P Cross
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom; and
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26
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Silver RT, Barel AC, Lascu E, Ritchie EK, Roboz GJ, Christos PJ, Orazi A, Hassane DC, Tam W, Cross NCP. The effect of initial molecular profile on response to recombinant interferon-α (rIFNα) treatment in early myelofibrosis. Cancer 2017; 123:2680-2687. [DOI: 10.1002/cncr.30679] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/11/2017] [Accepted: 01/12/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Richard T. Silver
- Richard T Silver, MD Myeloproliferative Neoplasms Center, Division of Hematology-Medical Oncology; Weill Cornell Medicine; New York New York
| | - Ariella C. Barel
- Richard T Silver, MD Myeloproliferative Neoplasms Center, Division of Hematology-Medical Oncology; Weill Cornell Medicine; New York New York
| | - Elena Lascu
- Richard T Silver, MD Myeloproliferative Neoplasms Center, Division of Hematology-Medical Oncology; Weill Cornell Medicine; New York New York
| | - Ellen K. Ritchie
- Richard T Silver, MD Myeloproliferative Neoplasms Center, Division of Hematology-Medical Oncology; Weill Cornell Medicine; New York New York
| | - Gail J. Roboz
- Richard T Silver, MD Myeloproliferative Neoplasms Center, Division of Hematology-Medical Oncology; Weill Cornell Medicine; New York New York
| | - Paul J. Christos
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research; Weill Cornell Medicine; New York New York
| | - Attilio Orazi
- Department of Pathology and Laboratory Medicine; Weill Cornell Medicine; New York New York
| | - Duane C. Hassane
- Institute for Computational Biomedicine, Division of Hematology and Medical Oncology, Department of Medicine; Weill Cornell Medicine; New York New York
| | - Wayne Tam
- Department of Pathology and Laboratory Medicine; Weill Cornell Medicine; New York New York
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Guglielmelli P, Pietra D, Pane F, Pancrazzi A, Cazzola M, Vannucchi AM, Tura S, Barosi G. Recommendations for molecular testing in classical Ph1-neg myeloproliferative disorders-A consensus project of the Italian Society of Hematology. Leuk Res 2017; 58:63-72. [PMID: 28460339 DOI: 10.1016/j.leukres.2017.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/26/2017] [Accepted: 04/20/2017] [Indexed: 12/21/2022]
Abstract
The discovery that Philadelphia-negative classical myeloproliferative neoplasms (MPNs) present with several molecular abnormalities, including the mostly represented JAK2V617F mutation, opened new horizons in the diagnosis, prognosis, and monitoring of these disorders. However, the great strides in the knowledge on molecular genetics need parallel progresses on the best approach to methods for detecting and reporting disease-associated mutations, and to shape the most effective and rationale testing pathway in the diagnosis, prognosis and monitoring of MPNs. The MPN taskforce of the Italian Society of Hematology (SIE) assessed the scientific literature and composed a framework of the best, possibly evidence-based, recommendations for optimal molecular methods as well as insights about the applicability and interpretation of those tests in the clinical practice, and clinical decision for testing MPNs patients. The issues dealt with: source of samples and nucleic acid template, the most appropriate molecular abnormalities and related detection methods required for diagnosis, prognosis, and monitoring of MPNs, how to report a diagnostic molecular test, calibration and quality control. For each of these issues, practice recommendations were provided.
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Affiliation(s)
- Paola Guglielmelli
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniela Pietra
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | | | - Alessandro Pancrazzi
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mario Cazzola
- Department of Molecular Medicine, University of Pavia, Pavia, Italy; Department of Haematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - Alessandro M Vannucchi
- CRIMM-Centro Ricerca e Innovazione delle Malattie Mieloproliferative, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Giovanni Barosi
- Center for the Study of Myelofibrosis, Biotechnology Research Area, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo, Pavia, Italy.
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Pavlov I, Hadjiev E, Alaikov T, Spassova S, Stoimenov A, Naumova E, Shivarov V, Ivanova M. Calreticulin Mutations in Bulgarian MPN Patients. Pathol Oncol Res 2017; 24:171-174. [PMID: 28411309 DOI: 10.1007/s12253-017-0226-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 04/03/2017] [Indexed: 10/19/2022]
Abstract
Somatic mutations in JAK2, MPL and CALR are recurrently identified in most of the cases with Philadelphia chromosome negative myeloproliferative neoplasms (MPNs). We applied four molecular genetic methods for identification of CALR exon 9 mutations, including high resolution melt (HRM) analysis, Sanger sequencing, semiconductor target genes sequencing and whole exome sequencing. A total of 78 patients with myeloid malignancies were included in the study. We identified 14 CALR exon 9 mutated cases out of 78 studied patients with myeloid malignancies. All mutated patients were diagnosed with MPN being either PMF (n = 7) or ET (n = 7). Nine cases had type 1 mutations and 5 cases had type 2 mutations. CALR exon 9, MPL exon 10 and JAK2 p. V617F were mutually exclusive. There were no statistically significant differences in the hematological parameters between the cases with CALR and JAK2 or MPL mutations. Notably, all four techniques were fully concordant in the detection of CALR mutations. This is one of the few reports on the CALR mutations frequency in South-eastern populations. Our study shows that the frequency and patterns of these mutations is identical to those in the patients' cohorts from Western countries. Besides we demonstrated the utility of four different methods for their detection.
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Affiliation(s)
- Ivan Pavlov
- Laboratory of Clinical Immunology, Alexandrovska University Hospital, Medical University, 1 Georgi Sofiisky Blvd, 1431, Sofia, Bulgaria
| | - Evgueniy Hadjiev
- Department of Clinical Hematology, Alexandrovska University Hospital, Medical University, Sofia, Bulgaria
| | - Tzvetan Alaikov
- Department of Clinical Hematology, Sofiamed University Hospital, Sofia, Bulgaria
| | - Sylva Spassova
- Department of Clinical Hematology, Sofiamed University Hospital, Sofia, Bulgaria
| | - Angel Stoimenov
- Laboratory of Transfusion Medicine, Sofiamed University Hospital, Sofia, Bulgaria
| | - Elissaveta Naumova
- Laboratory of Clinical Immunology, Alexandrovska University Hospital, Medical University, 1 Georgi Sofiisky Blvd, 1431, Sofia, Bulgaria
| | - Velizar Shivarov
- Department of Clinical Hematology, Sofiamed University Hospital, Sofia, Bulgaria.,Laboratory of Clinical Immunology, Sofiamed University Hospital, Sofia, Bulgaria
| | - Milena Ivanova
- Laboratory of Clinical Immunology, Alexandrovska University Hospital, Medical University, 1 Georgi Sofiisky Blvd, 1431, Sofia, Bulgaria.
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Jeong JH, Lee HT, Seo JY, Seo YH, Kim KH, Kim MJ, Lee JH, Park J, Hong JS, Park PW, Ahn JY. Screening PCR Versus Sanger Sequencing: Detection of CALR Mutations in Patients With Thrombocytosis. Ann Lab Med 2017; 36:291-9. [PMID: 27139600 PMCID: PMC4855047 DOI: 10.3343/alm.2016.36.4.291] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/01/2015] [Accepted: 01/14/2016] [Indexed: 01/25/2023] Open
Abstract
Background Mutations in calreticulin (CALR) have been reported to be key markers in the molecular diagnosis of myeloid proliferative neoplasms. In most previous reports, CALR mutations were analyzed by using Sanger sequencing. Here, we report a new, rapid, and convenient system for screening CALR mutations without sequencing. Methods Eighty-three bone marrow samples were obtained from 81 patients with thrombocytosis. PCR primers were designed to detect wild-type CALR (product: 357 bp) and CALR with type 1 (product: 302 bp) and type 2 mutations (product: 272 bp) in one reaction. The results were confirmed by Sanger sequencing and compared with results from fragment analysis. Results The minimum detection limit of the screening PCR was 10 ng for type 1, 1 ng for type 2, and 0.1 ng for cases with both mutations. CALR type 1 and type 2 mutants were detected with screening PCR with a maximal analytical sensitivity of 3.2% and <0.8%, respectively. The screening PCR detected 94.1% (16/17) of mutation cases and showed concordant results with sequencing in the cases of type 1 and type 2 mutations. Sanger sequencing identified one novel mutation (c.1123_1132delinsTGC). Compared with sequencing, the screening PCR showed 94.1% sensitivity, 100.0% specificity, 100.0% positive predictive value, and 98.5% negative predictive value. Compared with fragment analysis, the screening PCR presented 88.9% sensitivity and 100.0% specificity. Conclusions This screening PCR is a rapid, sensitive, and cost-effective method for the detection of major CALR mutations.
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Affiliation(s)
- Ji Hun Jeong
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Hwan Tae Lee
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Ja Young Seo
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yiel Hea Seo
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Kyung Hee Kim
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Moon Jin Kim
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae Hoon Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jinny Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jun Shik Hong
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Pil Whan Park
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
| | - Jeong Yeal Ahn
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
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Keaney T, O'Connor L, Krawczyk J, Abdelrahman MA, Hayat AH, Murray M, O'Dwyer M, Percy M, Langabeer S, Haslam K, Glynn B, Mullen C, Keady E, Lahiff S, Smith TJ. A novel molecular assay using hybridisation probes and melt curve analysis for CALR exon 9 mutation detection in myeloproliferative neoplasms. J Clin Pathol 2017; 70:662-668. [PMID: 28143941 DOI: 10.1136/jclinpath-2016-204205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022]
Abstract
AIMS Somatic insertions/deletions in exon 9 of the calreticulin gene have been identified in patients with essential thrombocythemia and primary myelofibrosis. Over 55 mutations have been discovered, 80% of which consist of either type 1 52-bp deletion or type 2 5-bp insertion. Other mutations (types 3-5) in conjunction with types 1 and 2 account for >87% of identified mutations. The aim of this study was development of a rapid PCR-based assay using LightCycler Hybridisation Probes for the detection of type 1-5 CALR mutations. METHOD A real-time PCR assay using a novel HybProbe set was developed for use on the LightCycler 480 Instrument II. The acceptor probe was labelled with LC640 and Faststart DNA Master HybProbe kit was used for PCR reactions. RESULTS Assay limit of detection was determined to be seven target copies with a probability of 95%. The specificity of the assay was determined by using synthetic constructs of CALR wild-type and CALR mutation types 1-5 with no non-specific detection observed. Samples from 21 patients with essential thrombocythemia (ET) and 12 patients with primary myelofibrosis (PMF), together with 29 control samples from patients diagnosed with various conditions, were screened using the assay. Of these, 24 were found to have mutations in CALR exon 9, with the assay detecting 8 type 1 mutations, 12 type 2 mutations, 2 type 24 mutations, 1 type 20 mutation and 1 31-bp deletion. CONCLUSIONS The novel assay described has potential for application as a rapid, sensitive, high-throughput screening method in the clinical diagnostics setting.
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Affiliation(s)
- Thomas Keaney
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland
| | - Louise O'Connor
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland.,Molecular Diagnostic Research Group, School of Natural Sciences, National University of Ireland, Galway, Ireland
| | - Janusz Krawczyk
- Department of Haematology, National University of Ireland, Galway, Ireland.,Galway University Hospital, Galway, Ireland
| | - Moutaz A Abdelrahman
- Department of Haematology, National University of Ireland, Galway, Ireland.,Galway University Hospital, Galway, Ireland
| | - Amjad H Hayat
- Department of Haematology, National University of Ireland, Galway, Ireland.,Galway University Hospital, Galway, Ireland
| | - Margaret Murray
- Department of Haematology, National University of Ireland, Galway, Ireland.,Galway University Hospital, Galway, Ireland
| | - Michael O'Dwyer
- Department of Haematology, National University of Ireland, Galway, Ireland.,Galway University Hospital, Galway, Ireland
| | - Melanie Percy
- Department of Haematology, Belfast City Hospital, Belfast, UK
| | | | - Karl Haslam
- Cancer Molecular Diagnostics, St. James's Hospital, Dublin, Ireland
| | - Barry Glynn
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland
| | - Ciara Mullen
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland
| | - Evelyn Keady
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland
| | - Sinéad Lahiff
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland
| | - Terry J Smith
- Research and Development Division, Advanced Molecular Systems, Galway, Ireland.,Molecular Diagnostic Research Group, School of Natural Sciences, National University of Ireland, Galway, Ireland
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Wang J, Zhang B, Chen B, Zhou RF, Zhang QG, Li J, Yang YG, Zhou M, Shao XY, Xu Y, Xu XH, Ouyang J, Xu J, Ye Q. JAK2, MPL, and CALR mutations in Chinese Han patients with essential thrombocythemia. ACTA ACUST UNITED AC 2016; 22:145-148. [PMID: 27875935 DOI: 10.1080/10245332.2016.1252003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Mutations in Janus kinase 2 (JAK2), myeloproliferative leukemia (MPL), and CALR are highly relevant to Philadelphia chromosome (Ph)-negative myeloproliferative neoplasms. METHODS Assessing the prevalence of molecular mutations in Chinese Han patients with essential thrombocythemia (ET), and correlating their mutational profile with disease characteristics/phenotype. RESULTS Of the 110 subjects studied, 62 carried the JAK2 V617F mutation, 21 had CALR mutations, one carried an MPL (W515) mutation, and 28 had non-mutated JAK2, CALR, and MPL (so-called triple-negative ET). Mutations in JAK2 exon 12 were not detected in any patient. Two ET patients had both CALR and JAK2 V617F mutations. Comparing the hematological parameters of the patients with JAK2 mutations with those of the patients with CALR mutations showed that the ET patients with CALR mutations were younger (p = 0.045) and had higher platelet counts (p = 0.043). CONCLUSION Genotyping for CALR could be a useful diagnostic tool for JAK2/MPL-negative ET, since the data suggest that CALR is much more prevalent than MPL, therefore testing for CALR should be considered in patients who are JAK2 negative as its frequency is almost 20 times that of MPL mutation.
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Affiliation(s)
- Jing Wang
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Biao Zhang
- b Department of Pathology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Bing Chen
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Rong-Fu Zhou
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Qi-Guo Zhang
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Juan Li
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Yong-Gong Yang
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Min Zhou
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Xiao-Yan Shao
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Yong Xu
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Xi-Hui Xu
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Jian Ouyang
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Jingyan Xu
- a Department of Hematology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
| | - Qing Ye
- b Department of Pathology , The Affiliated DrumTower Hospital of Nanjing University Medical School , Nanjing , Jiangsu , PR China
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Pomalidomide in myeloproliferative neoplasm-associated myelofibrosis. Leukemia 2016; 31:889-895. [PMID: 27774990 DOI: 10.1038/leu.2016.299] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/10/2016] [Accepted: 10/18/2016] [Indexed: 01/08/2023]
Abstract
Myeloproliferative neoplasm (MPN)-associated myelofibrosis is a MPN characterized by bone marrow fibrosis, cytopenias, splenomegaly and constitutional symptoms. Pomalidomide, an immune-modifying drug, is reported to improve anaemia and thrombocytopenia in some patients with MPN-associated myelofibrosis. We designed a phase 2 study of pomalidomide in patients with MPN-associated myelofibrosis and anaemia and/or thrombocytopenia and/or neutropenia. Subjects received pomalidomide 2.0 mg/day in cohort 1 (n=38) or 0.5 mg/day in cohort 2 (n=58). Prednisolone was added if there was no response after 3 months in cohort 1 and based on up-front randomization in cohort 2 if there was no response at 3 or 6 months. Response rates were 39% (95% confidence interval (CI), 26-55%) in cohort 1 and 24% (95% CI, 15-37%) in cohort 2. In a multivariable logistic regression model pomalidomide at 2.0 mg/day (odds ratio (OR), 2.62; 95% CI, 1.00-6.87; P=0.05) and mutated TET2 (OR, 5.07; 95% CI, 1.16-22.17; P=0.03) were significantly associated with responses. Median duration of responses was 13.0 months (range 0.9-52.7). There was no significant difference in response rates or duration in subjects receiving or not receiving prednisolone. Clinical trial MPNSG 01-09 is registered at ClinicalTrials.gov (NCT00949364) and clinicaltrialsregister.eu (EudraCT Number: 2009-010738-23).
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Monitoring Minimal Residual Disease in the Myeloproliferative Neoplasms: Current Applications and Emerging Approaches. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7241591. [PMID: 27840830 PMCID: PMC5093244 DOI: 10.1155/2016/7241591] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 10/05/2016] [Indexed: 11/18/2022]
Abstract
The presence of acquired mutations within the JAK2, CALR, and MPL genes in the majority of patients with myeloproliferative neoplasms (MPN) affords the opportunity to utilise these mutations as markers of minimal residual disease (MRD). Reduction of the mutated allele burden has been reported in response to a number of therapeutic modalities including interferon, JAK inhibitors, and allogeneic stem cell transplantation; novel therapies in development will also require assessment of efficacy. Real-time quantitative PCR has been widely adopted for recurrent point mutations with assays demonstrating the specificity, sensitivity, and reproducibility required for clinical utility. More recently, approaches such as digital PCR have demonstrated comparable, if not improved, assay characteristics and are likely to play an increasing role in MRD monitoring. While next-generation sequencing is increasingly valuable as a tool for diagnosis of MPN, its role in the assessment of MRD requires further evaluation.
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Kjær L, Cordua S, Holmström MO, Thomassen M, Kruse TA, Pallisgaard N, Larsen TS, de Stricker K, Skov V, Hasselbalch HC. Differential Dynamics of CALR Mutant Allele Burden in Myeloproliferative Neoplasms during Interferon Alfa Treatment. PLoS One 2016; 11:e0165336. [PMID: 27764253 PMCID: PMC5072743 DOI: 10.1371/journal.pone.0165336] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/10/2016] [Indexed: 11/18/2022] Open
Abstract
Discovery of somatic mutations in the calreticulin gene (CALR) has identified a subgroup of Philadelphia-negative chronic myeloproliferative neoplasms (MPN) with separate haematological characteristics and prognosis. CALR mutations serve as novel markers both of diagnostic value and as targets for monitoring molecular responses during therapy. Interferon-α (IFN) selectively targets the malignant clone in a subset of MPN patients and can induce both haematological and molecular remissions in CALR mutated essential thrombocythemia (ET) patients. We investigated the response to IFN in a cohort of 21 CALR mutated MPN patients including ET, prefibrotic primary myelofibrosis (pre-PMF), and primary myelofibrosis (PMF) with a median follow-up of 31 months. For evaluation of a molecular response, we developed highly sensitive quantitative PCR (qPCR) assays for monitoring the mutant allele burden of the two most prevalent CALR mutations (type 1 and type 2). Thirteen patients (62%) experienced a decrease in the mutant allele burden with a median decline of 29% from baseline. However, only four patients, including patients with ET, pre-PMF, and PMF diagnosis, achieved molecular responder (MR) status with >50% reduction in mutant allele burden according to European LeukemiaNet (ELN) guidelines. MR patients displayed significant differences in the dynamics of the CALR mutant load with regard to time to response and dynamics in mutant allele burden after discontinuation of IFN treatment. Furthermore, we highlight the prognostic value of the CALR mutant allele burden by showing a close association with leucocyte- and platelet counts, hemoglobin concentration, in addition to plasma lactate dehydrogenase (LDH) irrespective of molecular response and treatment status.
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Affiliation(s)
- Lasse Kjær
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
- * E-mail:
| | - Sabrina Cordua
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
| | | | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Torben A Kruse
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Niels Pallisgaard
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - Thomas S. Larsen
- Department of Haematology, Odense University Hospital, Odense, Denmark
| | - Karin de Stricker
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Vibe Skov
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
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35
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Gardner JA, Peterson JD, Turner SA, Soares BL, Lancor CR, Dos Santos LL, Kaur P, Ornstein DL, Tsongalis GJ, de Abreu FB. Detection of CALR Mutation in Clonal and Nonclonal Hematologic Diseases Using Fragment Analysis and Next-Generation Sequencing. Am J Clin Pathol 2016; 146:448-55. [PMID: 27686171 DOI: 10.1093/ajcp/aqw129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES To describe three methods used to screen for frameshift mutations in exon 9 of the CALR gene. METHODS Genomic DNA from 47 patients was extracted from peripheral blood and bone marrow using the EZ1 DNA Blood Kit (Qiagen, Valencia, CA) and quantified by the Quant-iT PicoGreen dsDNA Assay Kit (Invitrogen, San Diego, CA). After clinical history, cytogenetics, and molecular tests, patients were diagnosed with either clonal or nonclonal hematologic diseases. CALR screening was primarily performed using fragment analysis polymerase chain reaction, then next-generation sequencing and Sanger sequencing. RESULTS Among the 18 patients diagnosed with clonal diseases, one had acute myeloid leukemia (positive for trisomy 8), and 17 had myeloproliferative neoplasms (MPNs), including chronic myeloid leukemia (CML), essential thrombocythemia (ET), primary myelofibrosis (PMF), and polycythemia vera (PV). Patients with CML were positive for the BCR-ABL1 fusion. Ten patients were positive for JAK2 (PMF, n = 1; ET, n = 2; PV, n = 7), and three were CALR positive (ET, n = 1; PMF, n = 2). Patients diagnosed with a nonclonal disease were negative for JAK2, BCR-ABL, and CALR mutations. CONCLUSIONS Screening for CALR mutations is essential in BCR-ABL-negative MPNs since it not only provides valuable diagnostic and prognostic information but also identifies potential treatment targets. Since this study describes the importance of screening for known and novel biomarkers, we described in detail three methods that could be easily integrated into a clinical laboratory.
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MESH Headings
- Calreticulin/genetics
- DNA Mutational Analysis
- Fusion Proteins, bcr-abl/genetics
- High-Throughput Nucleotide Sequencing
- Humans
- Janus Kinase 2/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Mutation
- Polycythemia Vera/diagnosis
- Polycythemia Vera/genetics
- Primary Myelofibrosis/diagnosis
- Primary Myelofibrosis/genetics
- Thrombocythemia, Essential/diagnosis
- Thrombocythemia, Essential/genetics
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Affiliation(s)
- Juli-Anne Gardner
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
| | - Jason D Peterson
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
| | - Scott A Turner
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
| | - Barbara L Soares
- Universidade Federal De Sao Joao Del Rei, Divinopolis, Minas Gerais, Brazil
| | - Courtney R Lancor
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
| | | | - Prabhjot Kaur
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
| | - Deborah L Ornstein
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
| | - Gregory J Tsongalis
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH,
| | - Francine B de Abreu
- From the Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, and Dartmouth Hitchcock Medical Center and Norris Cotton Cancer Center, Lebanon, NH
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36
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Anelli L, Zagaria A, Coccaro N, Tota G, Minervini A, Casieri P, Impera L, Minervini CF, Brunetti C, Ricco A, Orsini P, Cumbo C, Specchia G, Albano F. Droplet digital PCR assay for quantifying of CALR mutant allelic burden in myeloproliferative neoplasms. Ann Hematol 2016; 95:1559-60. [PMID: 27365140 DOI: 10.1007/s00277-016-2739-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Luisa Anelli
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Antonella Zagaria
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Nicoletta Coccaro
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Giuseppina Tota
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Angela Minervini
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Paola Casieri
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Luciana Impera
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Crescenzio Francesco Minervini
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Claudia Brunetti
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Alessandra Ricco
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Paola Orsini
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Cosimo Cumbo
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Giorgina Specchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy
| | - Francesco Albano
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy.
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Haslam K, Conneally E, Flynn CM, Cahill MR, Gilligan O, O'Shea D, Langabeer SE. CALR mutation profile in Irish patients with myeloproliferative neoplasms. Hematol Oncol Stem Cell Ther 2016; 9:112-5. [PMID: 27352261 DOI: 10.1016/j.hemonc.2016.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022] Open
Abstract
Insertion and/or deletion mutations of the CALR gene have recently been demonstrated to be the second most common driver mutations in the myeloproliferative neoplasms (MPNs) of essential thrombocythemia (ET) and primary myelofibrosis (PMF). Given the diagnostic and emerging prognostic significance of these mutations, in addition to the geographical heterogeneity reported, the incidence of CALR mutations was determined in an Irish cohort of patients with MPNs with a view to incorporate this analysis into a prospective screening program. A series of 202 patients with known or suspected ET and PMF were screened for the presence of CALR mutations. CALR mutations were detected in 58 patients. Type 1 and Type 1-like deletion mutations were the most common (n=40) followed by Type 2 and Type 2-like insertion mutations (n=17). The CALR mutation profile in Irish ET and PMF patients appears similar to that in other European populations. Establishment of this mutational profile allows the introduction of a rational, molecular diagnostic algorithm in cases of suspected ET and PMF that will improve clinical management.
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Affiliation(s)
- Karl Haslam
- Cancer Molecular Diagnostics, St. James's Hospital, Dublin, Ireland
| | | | | | - Mary R Cahill
- Department of Haematology, Cork University Hospital, Cork, Ireland
| | - Oonagh Gilligan
- Department of Haematology, Cork University Hospital, Cork, Ireland
| | - Derville O'Shea
- Department of Haematology, Cork University Hospital, Cork, Ireland
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Murugesan G, Guenther-Johnson J, Mularo F, Cook JR, Daly TM. Validation of a molecular diagnostic assay forCALRexon 9 indels in myeloproliferative neoplasms: identification of coexistingJAK2andCALRmutations and a novel 9 bp deletion inCALR. Int J Lab Hematol 2016; 38:284-97. [DOI: 10.1111/ijlh.12484] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/29/2016] [Indexed: 01/23/2023]
Affiliation(s)
- G. Murugesan
- Robert J. Tomsich Pathology and Laboratory Medicine Institute; Cleveland Clinic; Cleveland OH 44195 USA
| | - J. Guenther-Johnson
- Robert J. Tomsich Pathology and Laboratory Medicine Institute; Cleveland Clinic; Cleveland OH 44195 USA
| | - F. Mularo
- Robert J. Tomsich Pathology and Laboratory Medicine Institute; Cleveland Clinic; Cleveland OH 44195 USA
| | - J. R. Cook
- Robert J. Tomsich Pathology and Laboratory Medicine Institute; Cleveland Clinic; Cleveland OH 44195 USA
| | - T. M. Daly
- Robert J. Tomsich Pathology and Laboratory Medicine Institute; Cleveland Clinic; Cleveland OH 44195 USA
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Digital-PCR assay for screening and quantitative monitoring of calreticulin (CALR) type-2 positive patients with myelofibrosis following allogeneic stem cell transplantation. Bone Marrow Transplant 2016; 51:872-3. [PMID: 26878663 DOI: 10.1038/bmt.2016.14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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40
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Capricious CALR mutated clones in myeloproliferative neoplasms. Blood Cells Mol Dis 2016; 57:110-1. [PMID: 26777583 DOI: 10.1016/j.bcmd.2016.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/04/2016] [Accepted: 01/06/2016] [Indexed: 11/22/2022]
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41
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Mansier O, Migeon M, Saint-Lézer A, James C, Verger E, Robin M, Socié G, Bidet A, Mahon FX, Cassinat B, Lippert E. Quantification of the Mutant CALR Allelic Burden by Digital PCR. J Mol Diagn 2016; 18:68-74. [DOI: 10.1016/j.jmoldx.2015.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/07/2015] [Accepted: 07/22/2015] [Indexed: 01/07/2023] Open
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Mehrotra M, Luthra R, Singh RR, Barkoh BA, Galbincea J, Mehta P, Goswami RS, Jabbar KJ, Loghavi S, Medeiros LJ, Verstovsek S, Patel KP. Clinical validation of a multipurpose assay for detection and genotyping of CALR mutations in myeloproliferative neoplasms. Am J Clin Pathol 2015; 144:746-55. [PMID: 26486739 DOI: 10.1309/ajcp5la2lddnqnnc] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES To develop a polymerase chain reaction (PCR)-based approach to detect CALR mutations in myeloproliferative neoplasms (MPNs) in a clinical laboratory. METHODS DNA was extracted from bone marrow aspirate samples of 67 JAK2 wild-type MPNs (22 with matched peripheral blood), 54 cases of unclassifiable myelodysplastic syndrome/MPN, and 16 cases of atypical chronic myeloid leukemia. We used genomic DNA to detect somatic mutations in exon 9 of CALR and PCR with fluorescently labeled and M13-tagged primers and subjected the products to capillary electrophoresis (CE) followed by Sanger sequencing. Detailed assay performance characteristics were established. RESULTS We identified CALR mutations in 19 (28.4%) of 67 JAK2-negative MPNs, including 14 type I (52-base pair [bp] deletion), four type II (5-bp insertions), and one type III (18-bp deletion). All mutations were confirmed by Sanger sequencing. Sensitivity studies showed 2.5% and 5% mutation detection levels by CE and Sanger sequencing, respectively, with high reproducibility. CONCLUSIONS This assay allows for rapid, convenient screening for CALR mutations in MPNs, thereby reducing the number of cases that require assessment by Sanger sequencing, reducing labor and improving turnaround time.
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Maier CL, Fisher KE, Jones HH, Hill CE, Mann KP, Zhang L. Development and validation of CALR mutation testing for clinical diagnosis. Am J Clin Pathol 2015; 144:738-45. [PMID: 26486738 DOI: 10.1309/ajcpxpa83mvctsoq] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To validate a diagnostic assay for detecting CALR mutations in the clinical setting. METHODS Traditional polymerase chain reaction (PCR) was performed on DNA previously extracted from 60 specimens (30 bone marrow aspirates [BMAs] and 30 peripheral blood [PB] samples) from 55 patients. Nearly all reported CALR mutations are insertions or deletions in exon 9. Therefore, we performed amplicon sizing by capillary electrophoresis and fragment length analysis (FLA) to determine mutation status. Mutations were confirmed by Sanger sequencing. RESULTS Fourteen samples from 10 patients with JAK2 and MPL wild-type myeloproliferative neoplasms were positive for CALR mutation. Detected mutations included a 52-base pair (bp) deletion (n = 6), a 5-bp insertion (n = 2), a 31-bp deletion (n = 1), and a 61-bp deletion (n = 1). Sanger sequencing of 15 samples showed 100% concordance. Matched patient PB and BMA samples (n = 5) harbored identical mutations, and samples run multiple times (n = 8) showed 100% reproducibility. CONCLUSIONS We conclude that CALR mutations may be quickly and accurately detected by FLA of PCR amplicons by capillary electrophoresis. These methods are routine procedures for most molecular laboratories and should allow for straightforward incorporation of the CALR assay into the clinical diagnostic testing menu.
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Calreticulin Mutations in Myeloproliferative Neoplasms: Comparison of Three Diagnostic Methods. PLoS One 2015; 10:e0141010. [PMID: 26501981 PMCID: PMC4621046 DOI: 10.1371/journal.pone.0141010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/02/2015] [Indexed: 01/01/2023] Open
Abstract
Calreticulin (CALR) mutations have recently been reported in 70–84% of JAK2V617F-negative myeloproliferative neoplasms (MPN), and this detection has become necessary to improve the diagnosis of MPN. In a large single-centre cohort of 298 patients suffering from Essential Thrombocythemia (ET), the JAK2V617F, CALR and MPL mutations were noted in 179 (60%), 56 (18.5%) and 13 (4.5%) respectively. For the detection of the CALR mutations, three methods were compared in parallel: high-resolution melting-curve analysis (HRM), product-sizing analysis and Sanger sequencing. The sensitivity for the HRM, product-sizing analysis and Sanger sequencing was 96.4%, 98.2% and 89.3% respectively, whereas the specificity was 96.3%, 100% and 100%. In our cohort, the product-sizing analysis was the most sensitive method and was the easiest to interpret, while the HRM was sometimes difficult to interpret. In contrast, when large series of samples were tested, HRM provided results more quickly than did the other methods, which required more time. Finally, the sequencing method, which is the reference method, had the lowest sensitivity but can be used to describe the type of mutation precisely. Altogether, our results suggest that in routine laboratory practice, product-sizing analysis is globally similar to HRM for the detection of CALR mutations, and that both may be used as first-line screening tests. If the results are positive, Sanger sequencing can be used to confirm the mutation and to determine its type. Product-sizing analysis provides sensitive and specific results, moreover, with the quantitative measurement of CALR, which might be useful to monitor specific treatments.
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Swierczek S, Lima LT, Tashi T, Kim SJ, Gregg XT, Prchal JT. Presence of polyclonal hematopoiesis in females with Ph-negative myeloproliferative neoplasms. Leukemia 2015; 29:2432-4. [PMID: 26369983 PMCID: PMC5083033 DOI: 10.1038/leu.2015.249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- S Swierczek
- Division of Hematology, Internal Medicine Department, University of Utah and VAH, Salt Lake City, UT, USA
| | - L T Lima
- Division of Hematology, Internal Medicine Department, University of Utah and VAH, Salt Lake City, UT, USA.,Department of Clinical Chemistry and Toxicology, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - T Tashi
- Division of Hematology, Internal Medicine Department, University of Utah and VAH, Salt Lake City, UT, USA
| | - S J Kim
- Division of Hematology, Internal Medicine Department, University of Utah and VAH, Salt Lake City, UT, USA
| | - X T Gregg
- Utah Cancer Specialists, Salt Lake City, UT, USA
| | - J T Prchal
- Division of Hematology, Internal Medicine Department, University of Utah and VAH, Salt Lake City, UT, USA.,ARUP Laboratories, Department of Hematopathology, Salt Lake City, UT, USA
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Luo W, Yu Z. Calreticulin (CALR) mutation in myeloproliferative neoplasms (MPNs). Stem Cell Investig 2015; 2:16. [PMID: 27358884 DOI: 10.3978/j.issn.2306-9759.2015.08.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 08/19/2015] [Indexed: 12/25/2022]
Abstract
As a heterogeneous group of disease, myeloproliferative neoplasms (MPNs) have confused hematologists and hematopathologists with their protean clinical presentations and myriads of morphologies. A thought of classifying MPNs based on molecular alterations has gained popularity because there is increasing evidence that molecular or chromosomal alterations have a better correlation with clinical presentation, response to therapies, and prognosis than conventional morphological classification. This type of efforts has been facilitated by the advancement of molecular technologies. A significant number of gene mutations have been identified in MPNs with JAK2 and MPL being the major ones. However, a significant gap is present in that many cases of MPNs do not harbor any of these mutations. This gap is recently filled by the discovery of Calreticulin (CALR) mutation in MPNs without JAK2 or MPL mutation and since then, the clinical and molecular correlation in MPNs has become a hot research topic. There seems to be a fairly consistent correlation between CALR mutation and certain hematological parameters such as a high platelet count and a better prognosis in MPNs with CALR mutation. However, controversies are present regarding the risks of thrombosis, interactions of CALR with other gene mutation, the role of CALR in the pathogenesis, and the optimal treatment strategies. In addition, there are many questions remain to be answered, which all boiled down to the molecular mechanisms by which CALR causes or contributes to MPNs. Here, we summarized current published literatures on CALR mutations in MPNs with an emphasis on the clinical-molecular correlation. We also discussed the controversies and questions remain to be answered.
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Affiliation(s)
- Wenyi Luo
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Zhongxin Yu
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
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Rapid and Sensitive Detection of Calreticulin Type 1 and 2 Mutations by Real-Time Quantitative PCR. Mol Diagn Ther 2015; 19:329-34. [DOI: 10.1007/s40291-015-0162-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Jeromin S, Kohlmann A, Meggendorfer M, Schindela S, Perglerová K, Nadarajah N, Kern W, Haferlach C, Haferlach T, Schnittger S. Next-generation deep-sequencing detects multiple clones of CALR mutations in patients with BCR-ABL1 negative MPN. Leukemia 2015. [PMID: 26220041 DOI: 10.1038/leu.2015.207] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- S Jeromin
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - A Kohlmann
- MLL Munich Leukemia Laboratory, Munich, Germany
| | | | - S Schindela
- MLL Munich Leukemia Laboratory, Munich, Germany
| | | | - N Nadarajah
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - W Kern
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - C Haferlach
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Haferlach
- MLL Munich Leukemia Laboratory, Munich, Germany
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Stein H, Bob R, Dürkop H, Erck C, Kämpfe D, Kvasnicka HM, Martens H, Roth A, Streubel A. A new monoclonal antibody (CAL2) detects CALRETICULIN mutations in formalin-fixed and paraffin-embedded bone marrow biopsies. Leukemia 2015. [PMID: 26202929 PMCID: PMC4705422 DOI: 10.1038/leu.2015.192] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recent advances in the diagnostic of myeloproliferative neoplasms (MPNs) discovered CALRETICULIN (CALR) mutations as a major driver in these disorders. In contrast to JAK2 mutations being mainly associated with polycythaemia vera, CALR mutations are only associated with primary myelofibrosis (PMF) and essential thrombocythaemia (ET). CALR mutations are present in the majority of PMF and ET patients lacking JAK2 and MPL mutations. As these CALR mutations are absent from reactive bone marrow (BM) lesions their presence indicates ET or PMF. So far these mutations are detectable only by molecular assays. Their molecular detection is cumbersome because of the great CALR mutation heterogeneity. Therefore, the availability of a simple assay would be of great help. All CALR mutations reported lead to a frameshift generating a new 36 amino-acid C-terminus. We generated a monoclonal antibody (CAL2) to this C-neoterminus by immunizing mice with a representative peptide and compared its performance with Sanger sequencing data in 173 MPNs and other BM diseases. There was a 100% correlation between the molecular and the CAL2 immunohistochemical (IHC) assays. Thus, the detection of CALR mutations by the CAL2 IHC is a specific, sensitive, rapid, simple and low-cost method.
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Affiliation(s)
- H Stein
- Reference and Consultation Center for Lymphoma and Haematopathology, Pathodiagnostik Berlin, Berlin, Germany
| | - R Bob
- Reference and Consultation Center for Lymphoma and Haematopathology, Pathodiagnostik Berlin, Berlin, Germany
| | - H Dürkop
- Reference and Consultation Center for Lymphoma and Haematopathology, Pathodiagnostik Berlin, Berlin, Germany
| | - C Erck
- Synaptic Systems GmbH, Göttingen, Germany
| | - D Kämpfe
- Praxis für Onkologie, Lüdenscheid, Germany
| | - H-M Kvasnicka
- Senckenbergisches Institut für Pathologie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany
| | - H Martens
- Synaptic Systems GmbH, Göttingen, Germany
| | - A Roth
- Medizinisches Versorgungszentrum am Helios Klinikum Emil von Behring, Labor für molekulare Diagnostik und Mikrobiologie, Berlin, Germany
| | - A Streubel
- Medizinisches Versorgungszentrum am Helios Klinikum Emil von Behring, Labor für molekulare Diagnostik und Mikrobiologie, Berlin, Germany
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