Epidemiology and clinical relevance of mutations in postpolycythemia vera and postessential thrombocythemia myelofibrosis: A study on 359 patients of the AGIMM group

Giada Rotunno, Annalisa Pacilli, Valentina Artusi, Elisa Rumi, Margherita Maffioli, Federica Delaini, Giada Brogi, Tiziana Fanelli, Alessandro Pancrazzi, Daniela Pietra, Isabella Bernardis, Clara Belotti, Lisa Pieri, Emanuela Sant'Antonio, Silvia Salmoiraghi, Daniela Cilloni, Alessandro Rambaldi, Francesco Passamonti, Tiziano Barbui, Rossella ManfrediniMario Cazzola, Enrico Tagliafico, Alessandro M. Vannucchi, Paola Guglielmelli

Research output: Contribution to journalArticle

Abstract

Transformation to secondary myelofibrosis (MF) occurs as part of the natural history of polycythemia vera (PPV-MF) and essential thrombocythemia (PET-MF). Although primary (PMF) and secondary MF are considered similar diseases and managed similarly, there are few studies specifically focused on the latter. The aim of this study was to characterize the mutation landscape, and describe the main clinical correlates and prognostic implications of mutations, in a series of 359 patients with PPV-MF and PET-MF. Compared with PV and ET, the JAK2V617F and CALR mutated allele burden was significantly higher in PPV-MF and/or PET-MF, indicating a role for accumulation of mutated alleles in the process of transformation to MF. However, neither the allele burden nor the type of driver mutation influenced overall survival (OS), while absence of any driver mutation (triple negativity) was associated with significant reduction of OS in PET-MF, similar to PMF. Of the five interrogated subclonal mutations (ASXL1, EZH2, SRSF2, IDH1, and IDH2), that comprise a prognostically detrimental high molecular risk (HMR) category in PMF, only SRSF2 mutations were associated with reduced survival in PET-MF, and no additional mutation profile with prognostic relevance was highlighted. Overall, these data indicate that the molecular landscape of secondary forms of MF is different from PMF, suggesting that unknown mutational events might contribute to the progression from chronic phase disease to myelofibrosis. These findings also support more extended genotyping approaches aimed at identifying novel molecular abnormalities with prognostic relevance for patients with PPV-MF and PET-MF. Am. J. Hematol. 91:681–686, 2016.

Original languageEnglish
Pages (from-to)681-686
Number of pages6
JournalAmerican Journal of Hematology
Volume91
Issue number7
DOIs
Publication statusPublished - Jul 1 2016

ASJC Scopus subject areas

  • Hematology

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    Rotunno, G., Pacilli, A., Artusi, V., Rumi, E., Maffioli, M., Delaini, F., Brogi, G., Fanelli, T., Pancrazzi, A., Pietra, D., Bernardis, I., Belotti, C., Pieri, L., Sant'Antonio, E., Salmoiraghi, S., Cilloni, D., Rambaldi, A., Passamonti, F., Barbui, T., ... Guglielmelli, P. (2016). Epidemiology and clinical relevance of mutations in postpolycythemia vera and postessential thrombocythemia myelofibrosis: A study on 359 patients of the AGIMM group. American Journal of Hematology, 91(7), 681-686. https://doi.org/10.1002/ajh.24377