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JAK2 V617F monitoring in polycythemia vera and essential thrombocythemia: Clinical usefulness for predicting myelofibrotic transformation and thrombotic events
Author(s) -
AlvarezLarrán Alberto,
Bellosillo Beatriz,
Pereira Arturo,
Kerguelen Ana,
Carlos HernándezBoluda Juan,
MartínezAvilés Luz,
FernándezRodríguez Concepción,
Gómez Montse,
Lombardía Luis,
Angona Anna,
Ancochea Águeda,
Senín Alicia,
Longarón Raquel,
Navarro Blanca,
Collado María,
Besses Carlos
Publication year - 2014
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23676
Subject(s) - essential thrombocythemia , polycythemia vera , medicine , incidence (geometry) , gastroenterology , thrombosis , jak2 v617f , risk factor , allele , myelofibrosis , biology , genetics , bone marrow , physics , optics , gene
The JAK2 V617F allele burden has been identified as a risk factor for vascular events and myelofibrotic transformation in polycythemia vera (PV) and essential thrombocythemia (ET). However, all previous studies have evaluated a single time point JAK2 V617F measurement. Therefore, the frequency and the clinical significance of changes in the JAK2 V617F mutant load occurring during the disease evolution remain unknown. In the present study, JAK2 V617F monitoring was performed during the follow‐up of 347 patients (PV = 163, ET = 184). According to their JAK2 V617F evolutionary patterns, patients were stratified as stable < 50% ( n = 261), stable ≥50% ( n = 52), progressive increase ( n = 24) and unexplained decrease ( n = 10). After a 2,453 person‐years follow‐up, a total of 59 thrombotic events, 16 major hemorrhages, and 27 cases of myelofibrotic transformations were registered. At multivariate analyses, patients with a persistently high (≥50%) or unsteady JAK2 V617F load during follow‐up had an increased risk of myelofibrotic transformation (Incidence rate ratio [IRR]: 20.7, 95% CI: 6.5–65.4; P < 0.001) and a trend for a higher incidence of thrombosis (IRR: 1.7, 1–3.3; P = 0.05) than patients with a stable allele burden below 50%. In conclusion, JAK2 V617F monitoring could be useful in patients with PV and ET for predicting disease's complications, especially myelofibrotic transformation. Am. J. Hematol. 89:517–523, 2014. © 2014 Wiley Periodicals, Inc.