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Blood, 1 March 2008, Vol. 111, No. 5, pp. 2785-2789.
Prepublished online as a Blood First Edition Paper on November 15, 2007; DOI 10.1182/blood-2007-06-095703.
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Submitted June 13, 2007
Accepted November 9, 2007
Host genetic variation contributes to phenotypic diversity in myeloproliferative disorders
Animesh Pardanani*, Brooke L Fridley, Terra L Lasho, D Gary Gilliland, and Ayalew Tefferi
Division of Hematology, Mayo Clinic, Rochester, MN, United States
Division of Biostatistics, Mayo Clinic, Rochester, MN, United States
Brigham and Women's Hospital and Dana-Farber Cancer Institute, & Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, United States
* Corresponding author; email: pardanani.animesh{at}mayo.edu.
JAK2V617F is an acquired mutation associated with polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). We tested the hypothesis that the paradox of a single disease allele associated with three distinctive clinical phenotypes could be explained in part by host modifying influences. We screened for genetic variation within four candidate genes involved in JAK-STAT signaling, including receptors for erythropoietin (EPOR), thrombopoietin (MPL), and granulocyte colony stimulating factor (GCSFR), and JAK2. We genotyped 32 linkage disequilibrium tag single nucleotide polymorphism (SNP) loci in 179 Caucasian patients-84 had PV, 58 PMF, and 37 ET. Genotype-phenotype analysis showed three JAK2 SNPs (rs7046736, rs10815148, rs12342421) to be significantly, but reciprocally associated with PV (p=0.000004, 0.000002, and 0.00006; odds ratio = 0.16, 2.72, and 2.46, respectively) and ET (p = 0.0007, 0.00019, and 0.00125; odds ratio = 3.05, 0.29, and 0.30, respectively), but not PMF. Three additional JAK2 SNPs (rs10758669, rs3808850, rs10974947) and a single EPOR SNP (rs318699) were also significantly associated with PV, but not ET or PMF. Finally, intragene haplotypes in JAK2 were significantly associated with PV only. Thus, host genetic variation may contribute to phenotypic diversity among myeloproliferative disorders, including in the presence of a shared disease allele.

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