JAK2 p.V617F allele burden in myeloproliferative neoplasms one month after allogeneic stem cell transplantation significantly predicts outcome and risk of relapse
Thoralf Lange,
Anja Edelmann,
Udo Siebolts,
Rainer Krahl,
Claudia Nehring,
Nadja Jäkel,
Michael Cross,
Jacqueline Maier,
Dietger Niederwieser,
Claudia Wickenhauser
Affiliations
Thoralf Lange
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Anja Edelmann
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Udo Siebolts
Institute of Pathology, University Hospital of Leipzig, Leipzig, Germany
Rainer Krahl
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Claudia Nehring
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Nadja Jäkel
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Michael Cross
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Jacqueline Maier
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Dietger Niederwieser
Department of Hematology/Oncology and Hemostaseology, University Hospital of Leipzig, Leipzig, Germany
Claudia Wickenhauser
Institute of Pathology, University Hospital of Leipzig, Leipzig, Germany
The risk profile and prognosis of patients with myelofibrosis is well described by the Dynamic International Prognostic Scoring System risk categorization. Allogeneic stem cell transplantation is considered for intermediate-2/high risk disease. However, indicators of prognosis after transplantation are still lacking. Seventy simultaneously collected pairs of trephine and blood samples were quantified for JAK2 p.V617F allele burden to compare test sensitivity. The course of 30 patients with JAK2 p.V617F-positive myeloproliferative neoplasia was correlated with allele burden after transplantation. Monitoring can be performed on full blood samples as well as trephine biopsies, provided that techniques with ample sensitivity (0.01% to 0.001%) are available. Measurement of allele burden on day 28 after transplantation discriminates two prognostic groups: patients with a JAK2 p.V617F allele burden >1% have a significantly higher risk of relapse of JAK2 p.V617F positive neoplasia (P=0.04) and a poorer overall survival (P
