Myeloproliferative Neoplasms: Contemporary Review and Molecular Landscape
Abstract
:1. Introduction and Brief Epidemiology
2. Molecular and Mutational Landscape
2.1. Role of Driver Mutations
2.2. Role of Non-Driver Mutations
2.3. Role of Megakaryocytes
2.4. Role of Endothelial Cells
2.5. Role of Innate and Acquired Immunity
3. Clinical Features of Myelofibrosis
4. MDS/MPN
5. Molecular and Mutational Landscape of MDS/MPNs
Differences in the Mutational Landscape of MDS/MPN and MF/MPN
6. Therapeutic Overview and Treatment Paradigm
6.1. Treatment of Chronic Phase MPN
6.2. Role of Cytoreductive Agents
6.3. Role of Interferons
6.4. Role of JAK Kinase Inhibitors
6.5. Accelerated MPN, Blast Phase, and Leukemic Transformation
6.6. Treatment of Accelerated MPN and MPN Blast Phase
6.7. Future Therapeutic Landscape
7. Conclusions
Funding
Conflicts of Interest
References
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Mutation Category | Relative Frequency (%) |
ASXL1 | 36 |
TET2 | 18 |
SRSF2 | 18 |
U2AF1 | 16 |
Class | Frequencies of Common Somatic Mutations | Cytogenetic Abnormalities | Incidence Rate in the US /100,000 |
Chronic myelomonocytic leukemia | TET2 (60%), SRSF2 (50%), ASXL (40%), NKRAS and JAK2 (40%) | Trisomy 8 (+8), −Y, (monosomy 7 and del7q), trisomy 21 (+21) [76] | 0.6 (0.57–0.63) |
Atypical chronic myeloid leukemia (aCML) | SETBP 1 (25–40%), ETNK1 (8%), ASXL1, EZH2, TET2, SRSF2, and N/KRAS | Trisomy 8, del(20q), −7/7q-, or isochromosome 17q [i17[q)] [77] | 0.060 (04–0.62) |
MDS/MPN with SF3B1 mutation and thrombocytosis | SFB3 (89.2%), JAK 2, | Trisomy 8 | Less than 1% of all new MDS/MPN cases |
MDS/MPN NOS | ASXL1 (29–56%), TP53 (8–9%), SRSF2, SETBP1, JAK2V617F, NRAS, and TET2 | Trisomy 8, monosomy 7, deletion 7q, and deletion 20q. | 0.07 (0.006–0.009) |
Phenotypic Stage | Blast Percentage | Comment |
MPN CP | Less than 10% of blasts | May have a static course or progress to advanced disease depending on genetic risk profile |
MPN AP | 10 to 19% of blasts | |
MPN BP | Greater than 20% of blasts |
Class | Examples |
JAK kinase inhibitors | Ruxolitinib, fedratinib |
Combined JAK 2 and FLT3 inhibitors | Pacritinib–fedratinib |
Cytoreductive agents | Hydroxyurea |
Interferons | Ropeginterferon alfa-2b |
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Mahmud, M.; Vasireddy, S.; Gowin, K.; Amaraneni, A. Myeloproliferative Neoplasms: Contemporary Review and Molecular Landscape. Int. J. Mol. Sci. 2023, 24, 17383. https://doi.org/10.3390/ijms242417383
Mahmud M, Vasireddy S, Gowin K, Amaraneni A. Myeloproliferative Neoplasms: Contemporary Review and Molecular Landscape. International Journal of Molecular Sciences. 2023; 24(24):17383. https://doi.org/10.3390/ijms242417383
Chicago/Turabian StyleMahmud, Muftah, Swati Vasireddy, Krisstina Gowin, and Akshay Amaraneni. 2023. "Myeloproliferative Neoplasms: Contemporary Review and Molecular Landscape" International Journal of Molecular Sciences 24, no. 24: 17383. https://doi.org/10.3390/ijms242417383