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Blood, 1 August 2008, Vol. 112, No. 3, pp. 844-847.
Prepublished online as a Blood First Edition Paper on June 2, 2008; DOI 10.1182/blood-2008-01-135897.


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NEOPLASIA

Brief Report

Characteristics and clinical correlates of MPL 515W>L/K mutation in essential thrombocythemia

Alessandro M. Vannucchi1,2, Elisabetta Antonioli1,2, Paola Guglielmelli1,2, Alessandro Pancrazzi1,2, Vittoria Guerini3, Giovanni Barosi4, Marco Ruggeri5, Giorgina Specchia6, Francesco Lo-Coco7, Federica Delaini3, Laura Villani4, Silvia Finotto5, Emanuele Ammatuna7, Renato Alterini1,2, Valentina Carrai1,2, Gloria Capaccioli1,2, Simonetta Di Lollo8, Vincenzo Liso6, Alessandro Rambaldi3, Alberto Bosi1,2, and Tiziano Barbui3

1 Unita Funzionale di Ematologia, Dipartimento di Area Critica Medico-Chirurgica, Università degli Studi, Firenze; 2 Istituto Toscano Tumori, Firenze; 3 Divisione di Ematologia, Ospedali Riuniti, Bergamo, 4 Laboratorio di Epidemiologia Clinica, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo, Pavia; 5 Dipartimento di Ematologia e Centro per l'Emofilia e la Trombosi, Ospedale San Bortolo, Vicenza; 6 Dipartimento di Ematologia, Università degli Studi, Bari; 7 Dipartimento di Biopatologia e Diagnostica per Immagini, Università Tor Vergata, Roma; and 8 Dipartimento di Oncologia, Università degli Studi, Firenze, Italy

Among 994 patients with essential thrombocythemia (ET) who were genotyped for the MPLW515L/K mutation, 30 patients carrying the mutation were identified (3.0%), 8 of whom also displayed the JAK2V671F mutation. MPLW515L/K patients presented lower hemoglobin levels and higher platelet counts than did wild type (wt) MPL; these differences were highly significant compared with MPLwt/JAK2V617F–positive patients. Reduced hemoglobin and increased platelet levels were preferentially associated with the W515L and W515K alleles, respectively. MPL mutation was a significant risk factor for microvessel disturbances, suggesting platelet hyperreactivity associated with constitutively active MPL; arterial thromboses were increased only in comparison to MPLwt/JAK2wt patients. MPLW515L/K patients presented reduced total and erythroid bone marrow cellularity, whereas the numbers of megakaryocytes, megakaryocytic clusters, and small-sized megakaryocytes were all significantly increased. These data indicate that MPLW515L/K mutations do not define a distinct phenotype in ET, although some differences depended on the JAK2V617F mutational status of the counterpart.


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