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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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