Vascular events in Korean patients with myeloproliferative neoplasms and their relationship to JAK2 mutation

Soo-Mee Bang; Jong-Seok Lee; Jeong Yeal Ahn; Jae Hoon Lee; Myung Soo Hyun; Bong Seog Kim; Moo Rim Park; Hyun-Sook Chi; Ho Young Kim; Hyo Jung Kim; Moon Hee Lee; Hwak Kim; Jong Ho Won; Hwi Joong Yoon; Do-yeun Oh; Eun-Mi Nam; Sung Hwa Bae; Byoung-Kook Kim; for the Korean MPN Working Party

doi:10.1160/TH08-06-0396

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2009; 101(03): 547-551
DOI: 10.1160/TH08-06-0396

Cellular Proteolysis and Oncology

Schattauer GmbH

Vascular events in Korean patients with myeloproliferative neoplasms and their relationship to JAK2 mutation

Soo-Mee Bang

¹Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of

,

Jong-Seok Lee

¹Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of

,

Jeong Yeal Ahn

²Laboratory Medicine, and

,

Jae Hoon Lee

³Internal Medicine, Gachon University Gil Hospital, Incheon, Korea

,

Myung Soo Hyun

⁴Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea

,

Bong Seog Kim

⁵Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea

,

Moo Rim Park

⁶Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea

,

Hyun-Sook Chi

⁷Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea

,

Ho Young Kim

⁸Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea

,

Hyo Jung Kim

⁸Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea

,

Moon Hee Lee

⁹Department of Internal Medicine, Inha University Hospital, Incheon, Korea

,

Hwak Kim

¹⁰Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea

,

Jong Ho Won

¹¹Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea

,

Hwi Joong Yoon

¹²Department of Internal Medicine, Kyunghee University Hospital, Seoul, Korea

,

Do-yeun Oh

¹³Department of Internal Medicine, Pochon CHA University College of Medicine, Seongnam, Korea

,

Eun-Mi Nam

¹⁴Department of Internal Medicine, Ewha Women’s University Hospital, Seoul, Korea

,

Sung Hwa Bae

¹⁵Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea

,

Byoung-Kook Kim

¹⁶Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

,

for the Korean MPN Working Party

› Author Affiliations

Abstract

Summary

Evaluation of the Janus kinase 2 (JAK2) V617F mutation has been widely used for the diagnosis of myeloproliferative neoplasms (MPN). However, its prognostic relevance to clinical outcome is not completely understood. We investigated the association of JAK2 V617F with vascular events in Korean patients with myeloproliferative neoplasms (MPN). We studied 283 patients from 15 centers, who were diagnosed with MPN. The JAK2 V617F status was evaluated by allele-specific polymerase chain reaction (PCR) and sequencing. The patients’ diagnoses were essential thrombocythemia (ET n=146), polycythemia vera (PV n=120), primary myelofibrosis (n=12), and unclassifiable MPN (MPNu n=5). JAK2 V617F was detected in 89 (61%) patients with ET, 103 (86%) with PV, four (33%) with myelofibrosis, and four (80%) with MPNu. A higher number of leukocytes, haemoglobin levels and BM cellularity as well as an older age, lower platelet counts, and diagnosis of PV were significantly correlated with JAK2 V617F. Eighty-three and 43 episodes of thrombosis and bleeding occurred in 100 patients each before and after the diagnosis. Vascular events more frequently occurred in 37% of patients with JAK2 V617F than in 29% of those without the mutation (p=0.045). Among 175 patients whose samples were available for sequencing, 28 patients with homozygous JAK2 V617F had vascular events more frequently (57%) than those who were heterozygotes (39%) or had the wild type (27%) (p=0.03). The multivariate analysis showed that a JAK2 homozygous mutation, hypercholesterolemia and older age were independent risk factors for a vascular event. The results of this study showed that Korean patients with MPN had a similar JAK2 mutation rate and frequency of vascular events when compared to Western patients. The presence of V617F was significantly related to vascular events. Therefore, initial evaluation for the JAK2 mutation and careful monitoring for vascular events should be performed in MPN patients.

Keywords

Myeloproliferative disorders - Janus kinase 2 - thrombosis - bleeding

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References

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