Novel Advances in the Molecular Understanding of Myeloproliferative Neoplasms (MPNs)

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Molecular Cancer Biology".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2460

Special Issue Editors


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Guest Editor
1. Department of Hematology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
2. Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
Interests: MPNs; leukemia; lymphoma; CAR-T; HSCT; GVHD

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Guest Editor
The Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian, China
Interests: Chinese medicine; pharmacology; anti-aging; anti-inflammation

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Guest Editor
St. Jude Children's Research Hospital, Memphis, TN, USA
Interests: hematopoiesis; megakaryocytes; myeloproliferative neoplasms; acute myeloid leukemia; myelodysplastic syndrome
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Special Issue Information

Dear Colleagues,

Myeloproliferative neoplasms (MPNs) encompass a diverse group of hematologic malignancies, including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), as well as post-PV-MF and post-ET-MF. Progression to acute leukemia represents the most dreaded complication of the disease and a significant cause of mortality in MPN patients. 

MPNs present a wide spectrum of clinical manifestations and molecular abnormalities, complicating their diagnosis, classification, and treatment. Common driver mutations, such as Janus kinase 2 (JAK2), calreticulin (CALR), and myeloproliferative leukemia virus oncogene (MPL), lead to the constitutive activation of the JAK/STAT signaling pathway, a hallmark of MPN pathogenesis. These driver mutations are essential for the MPN phenotype. Concurrent somatic mutations, including transcription factors (e.g., Runx1), epigenetic regulators (e.g., TET2, ASXL1, and DNMT3A), signaling molecules (e.g., JAKs and NRAS), and splicing factors (e.g., SRSF2 and SF3B), also contribute to MPN development. 

Recent advancements in understanding the molecular pathogenesis and genetics of MPNs have prompted the investigation of various therapeutic agents targeting constitutively activated JAK/STAT with JAK inhibitors, such as ruxolitinib, fedratinib, pacritinib, and momelotinib, as well as MEK and ERK kinase inhibitors. While these treatments effectively alleviate clinical symptoms, none have demonstrated the ability to reduce mutant allele burden. The challenge lies in translating scientific discoveries into effective therapies to address this unmet medical need for MPN patients. 

This Special Issue aims to present the latest advances in exploring the molecular landscape of MPNs, offering a comprehensive overview of the role of molecular abnormalities in pathogenesis and discussing how these findings might guide treatments targeting vulnerabilities and reduce mutant allele burden in MPNs. 

Dr. Wei Chen
Dr. Fei Li
Dr. Qiang Jeremy Wen
Guest Editors

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Keywords

  • MPNs
  • ET
  • PV
  • PMF
  • post-PV-MF
  • post-ET-MF
  • MDS/MPN
  • JAK2

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Published Papers (2 papers)

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12 pages, 1535 KiB  
Article
Extreme Thrombocytosis in Patients with Overt Myelofibrosis and Its Clinical Associations
by Marko Lucijanic, Ivan Krecak, Ena Soric, Anica Sabljic, Davor Galusic, Hrvoje Holik, Vlatka Perisa, Martina Moric Peric, Ivan Zekanovic, Leonardo Budimir and Rajko Kusec
Cancers 2025, 17(9), 1390; https://doi.org/10.3390/cancers17091390 - 22 Apr 2025
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Abstract
Background/Objectives: Overt primary myelofibrosis (PMF), secondary post-polycythemia vera (post-PV), and post-essential thrombocythemia (post-ET) myelofibrosis (SMF) are chronic myeloproliferative neoplasms (MPN) that sometimes present with extreme thrombocytosis (ExTh, platelet count > 1000 × 109/L), a phenomenon of uncertain clinical significance since [...] Read more.
Background/Objectives: Overt primary myelofibrosis (PMF), secondary post-polycythemia vera (post-PV), and post-essential thrombocythemia (post-ET) myelofibrosis (SMF) are chronic myeloproliferative neoplasms (MPN) that sometimes present with extreme thrombocytosis (ExTh, platelet count > 1000 × 109/L), a phenomenon of uncertain clinical significance since there are no published data available. Methods: We retrospectively investigated the clinical correlations and associated outcomes of ExTh in a cohort of 172 patients with overt myelofibrosis diagnosed in six Croatian hematology centers. Results: ExTh was present in 5.8% of patients and was associated with post-ET etiology of myelofibrosis, older age, smaller spleen size, and the presence of arterial hypertension (p < 0.05 for all analyses). No significant associations were observed with sex, degree of bone marrow fibrosis, or driver mutation status. Over the follow-up period, patients with ExTh experienced a favorable course regarding survival (p < 0.001) and bleeding risk (p = 0.034), whereas no significant association with thrombotic risk was observed (p = 0.682). Conclusions: In contrast to its context in ET, ExTh in overt fibrotic MPN does not appear to confer higher bleeding or thrombotic risk. Instead, it is associated with more favorable survival outcomes and reduced bleeding risk. Full article
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21 pages, 4056 KiB  
Review
Chronic Neutrophilic Leukemia: Advances in Diagnosis, Genetic Insights, and Management Strategies
by Ismail Elbaz Younes, Pawel Mroz, Mehrnoosh Tashakori, Amira Hamed and Siddhartha Sen
Cancers 2025, 17(2), 227; https://doi.org/10.3390/cancers17020227 - 12 Jan 2025
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Abstract
CNL is a rare subtype of MPNs characterized by persistent neutrophilia, bone marrow hypercellularity, and specific genetic mutations, particularly in the CSF3R gene. Advances in molecular diagnostics have greatly enhanced our understanding of CNL, distinguishing it from other myeloproliferative disorders and refining diagnostic [...] Read more.
CNL is a rare subtype of MPNs characterized by persistent neutrophilia, bone marrow hypercellularity, and specific genetic mutations, particularly in the CSF3R gene. Advances in molecular diagnostics have greatly enhanced our understanding of CNL, distinguishing it from other myeloproliferative disorders and refining diagnostic criteria. This review provides an updated overview of CNL, focusing on breakthroughs in genetic profiling, including novel mutations with potential prognostic value and implications for targeted therapy. We discuss current management strategies, emphasizing the role of JAK inhibitors, allogeneic stem cell transplantation, and evolving investigational treatments. Challenges in early diagnosis, therapeutic resistance, and future directions in research are also addressed, underscoring the need for a personalized medicine approach to improve outcomes for patients with CNL. Full article
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