Functional Consequences of Mutations in Myeloproliferative Neoplasms
Driver mutations occur in Janus kinase 2 (JAK2), thrombopoietin receptor (MPL), and calreticulin (CALR) in BCR-ABL1 negative myeloproliferative neoplasms (MPNs). From mutations leading to one amino acid substitution in JAK2 or MPL, to frameshift mutations in CALR resulting in a protein with a differ...
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doaj-f0613fee4a9d48b2994d7e5a824df8f72021-06-04T07:41:37ZengWolters KluwerHemaSphere2572-92412021-06-0156e57810.1097/HS9.0000000000000578202106000-00012Functional Consequences of Mutations in Myeloproliferative NeoplasmsStefan N. Constantinescu0William Vainchenker1Gabriel Levy2Nicolas Papadopoulos31 Ludwig Institute for Cancer Research, Brussels, Belgium5 INSERM, Unité Mixte de Recherche 1287, Institut Gustave Roussy, Villejuif, France1 Ludwig Institute for Cancer Research, Brussels, Belgium1 Ludwig Institute for Cancer Research, Brussels, BelgiumDriver mutations occur in Janus kinase 2 (JAK2), thrombopoietin receptor (MPL), and calreticulin (CALR) in BCR-ABL1 negative myeloproliferative neoplasms (MPNs). From mutations leading to one amino acid substitution in JAK2 or MPL, to frameshift mutations in CALR resulting in a protein with a different C-terminus, all the mutated proteins lead to pathologic and persistent JAK2-STAT5 activation. The most prevalent mutation, JAK2 V617F, is associated with the 3 entities polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), while CALR and MPL mutations are associated only with ET and MF. Triple negative ET and MF patients may harbor noncanonical mutations in JAK2 or MPL. One major fundamental question is whether the conformations of JAK2 V617F, MPL W515K/L/A, or CALR mutants differ from those of their wild type counterparts so that a specific treatment could target the clone carrying the mutated driver and spare physiological hematopoiesis. Of great interest, a set of epigenetic mutations can co-exist with the phenotypic driver mutations in 35%–40% of MPNs. These epigenetic mutations, such as TET2, EZH2, ASXL1, or DNMT3A mutations, promote clonal hematopoiesis and increased fitness of aged hematopoietic stem cells in both clonal hematopoiesis of indeterminate potential (CHIP) and MPNs. Importantly, the main MPN driver mutation JAK2 V617F is also associated with CHIP. Accumulation of several epigenetic and splicing mutations favors progression of MPNs to secondary acute myeloid leukemia. Another major fundamental question is how epigenetic rewiring due to these mutations interacts with persistent JAK2-STAT5 signaling. Answers to these questions are required for better therapeutic interventions aimed at preventing progression of ET and PV to MF, and transformation of these MPNs in secondary acute myeloid leukemia.http://journals.lww.com/10.1097/HS9.0000000000000578 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefan N. Constantinescu William Vainchenker Gabriel Levy Nicolas Papadopoulos |
spellingShingle |
Stefan N. Constantinescu William Vainchenker Gabriel Levy Nicolas Papadopoulos Functional Consequences of Mutations in Myeloproliferative Neoplasms HemaSphere |
author_facet |
Stefan N. Constantinescu William Vainchenker Gabriel Levy Nicolas Papadopoulos |
author_sort |
Stefan N. Constantinescu |
title |
Functional Consequences of Mutations in Myeloproliferative Neoplasms |
title_short |
Functional Consequences of Mutations in Myeloproliferative Neoplasms |
title_full |
Functional Consequences of Mutations in Myeloproliferative Neoplasms |
title_fullStr |
Functional Consequences of Mutations in Myeloproliferative Neoplasms |
title_full_unstemmed |
Functional Consequences of Mutations in Myeloproliferative Neoplasms |
title_sort |
functional consequences of mutations in myeloproliferative neoplasms |
publisher |
Wolters Kluwer |
series |
HemaSphere |
issn |
2572-9241 |
publishDate |
2021-06-01 |
description |
Driver mutations occur in Janus kinase 2 (JAK2), thrombopoietin receptor (MPL), and calreticulin (CALR) in BCR-ABL1 negative myeloproliferative neoplasms (MPNs). From mutations leading to one amino acid substitution in JAK2 or MPL, to frameshift mutations in CALR resulting in a protein with a different C-terminus, all the mutated proteins lead to pathologic and persistent JAK2-STAT5 activation. The most prevalent mutation, JAK2 V617F, is associated with the 3 entities polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), while CALR and MPL mutations are associated only with ET and MF. Triple negative ET and MF patients may harbor noncanonical mutations in JAK2 or MPL. One major fundamental question is whether the conformations of JAK2 V617F, MPL W515K/L/A, or CALR mutants differ from those of their wild type counterparts so that a specific treatment could target the clone carrying the mutated driver and spare physiological hematopoiesis. Of great interest, a set of epigenetic mutations can co-exist with the phenotypic driver mutations in 35%–40% of MPNs. These epigenetic mutations, such as TET2, EZH2, ASXL1, or DNMT3A mutations, promote clonal hematopoiesis and increased fitness of aged hematopoietic stem cells in both clonal hematopoiesis of indeterminate potential (CHIP) and MPNs. Importantly, the main MPN driver mutation JAK2 V617F is also associated with CHIP. Accumulation of several epigenetic and splicing mutations favors progression of MPNs to secondary acute myeloid leukemia. Another major fundamental question is how epigenetic rewiring due to these mutations interacts with persistent JAK2-STAT5 signaling. Answers to these questions are required for better therapeutic interventions aimed at preventing progression of ET and PV to MF, and transformation of these MPNs in secondary acute myeloid leukemia. |
url |
http://journals.lww.com/10.1097/HS9.0000000000000578 |
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